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Brain imaging and ultrasound of the carotid and vertebral arteries were all normal. Investigations revealed severe hyperlipidemia and a venous blood glucose level of 19.6\u2009mmol\/L despite a negative result on a 75\u2010g oral glucose tolerance test at 32\u2009weeks of pregnancy. Fundus photography demonstrated bilateral severe proliferative diabetic retinopathy with lipemia retinalis. The skin lesions were consistent with xanthomas on biopsy. The partial left sixth cranial nerve palsy and the bilateral rapidly progressive diabetic retinopathy were likely secondary to peripheral ischemia from serum hyperviscosity and displacement due to severe hyperlipidemia. The rapid progression of symptoms was likely triggered by a postpartum diet high in saturated fats in the context of presumed genetic predisposition.<\/jats:p>","DOI":"10.1111\/jog.15123","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T06:41:21Z","timestamp":1639032081000},"page":"483-491","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["New diagnosis of diabetes and severe hyperlipidemia at 3 months postpartum presenting as florid diabetic retinopathy and eruptive xanthomas"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8333-4502","authenticated-orcid":false,"given":"Xi May","family":"Zhen","sequence":"first","affiliation":[{"name":"Department of Endocrinology Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Department of Endocrinology John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuo Luong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shamasunder","family":"Acharya","sequence":"additional","affiliation":[{"name":"Department of Endocrinology John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,12,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1409"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-814823-5.00014-3"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-019-0238-5"},{"key":"e_1_2_8_5_1","unstructured":"NankervisAMH MosesR RossGP CallawayL PorterC JeffriesW BoormanC De VriesB McElduffAAustralasian Diabetes in Pregnancy Society.ADIPS Consensus Guidelines for the Testing and Diagnosis of Gestational Diabetes in Australia. 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