Asymptomatic Very Severe Hypertriglyceridemia in Poorly Controlled Type 2 Diabetes

Severe hypertriglyceridemia (HTG) is a potentially life-threatening metabolic complication with various possible presentations.We report a case of a middle-aged woman with a long-term history of uncontrolled type 2 diabetes mellitus (DM) who was admitted for hyperglycemia and found to have concomitant severe HTG, which remained asymptomatic throughout her hospitalization.The condition was managed with intravenous insulin and dextrose infusion, resulting in rapid and sustained reduction in triglyceride (TG) level as well as improved glycemic control.This case underscores the importance of early recognition of severe HTG in at-risk patients, even in the absence of classic symptoms.It also highlights the effectiveness of insulin-based therapy for both correcting metabolic derangements and preventing potential complications.Long-term management focusing on glycemic control, lipid-lowering therapy, medication adherence, and lifestyle modification is essential to prevent recurrence and complications and reduce cardiovascular risk.