{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:28:06Z","timestamp":1790206086126,"version":"4.1.0"},"reference-count":9,"publisher":"Bioscientifica","issue":"3","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"\n Summary<\/jats:title>\n Gestational diabetes mellitus (GDM) is a known risk factor for dyslipidaemias. Insulin resistance and the associated dyslipidaemia, particularly hypertriglyceridaemia, have been less frequently linked to peripheral nerve dysfunction, including small fibre sensory neuropathy. The relationship between metabolic disturbances, such as hypertriglyceridaemia, and neuropathy warrants further exploration and has gained increasing recognition in recent studies. This case highlights the potential neurological consequences of lipid abnormalities in women with a history of GDM. A 38-year-old woman presented to an endocrinologist with a 4-week history of paraesthesias and incidental findings of significantly elevated triglycerides (78.4 mmol\/L) and total cholesterol (14.7 mmol\/L). Initially, numbness began in her left first toe, spreading to other toes on the left foot, and then to the right foot, accompanied by hyperalgesia in fifth fingers bilaterally. She had no history of trauma or back injuries. Her medical history included insulin-dependent GDM and HELLP syndrome 4 years prior, endometriosis, and adenomyosis. With persistently high lipid levels (cholesterol: 12.1 mmol\/L; triglycerides: 18.5 mmol\/L), she was admitted to ICU for urgent lipid-lowering treatment but experienced hypoglycaemia on an insulin\u2013dextrose infusion. Repeat triglycerides the next day were 13.1 mmol\/L. A neurologist diagnosed her with small fibre sensory neuropathy secondary to hypertriglyceridaemia. Treatment with fenofibrate, high-dose fish oil, and a low-fat, low-carbohydrate diet was initiated with outpatient endocrinologist follow-up. Hypertriglyceridaemia is a significant health concern, potentially leading to severe complications such as peripheral neuropathy. Early intervention to optimise lipid levels is essential to prevent adverse outcomes.<\/jats:p>\n <\/jats:sec>\n \n Learning points<\/jats:title>\n \n \n GDM is known to be a risk factor for dyslipidaemias.<\/jats:p>\n <\/jats:list-item>\n \n Hypertriglyceridaemia can contribute to small fibre sensory neuropathy via mechanisms including microvascular ischaemia, oxidative stress, and inflammation affecting peripheral nerves.<\/jats:p>\n <\/jats:list-item>\n \n Diagnosis requires clinical correlation with lipid profiles and neurological findings, and exclusion of other causes through targeted investigations such as nerve conduction studies and autoimmune screening.<\/jats:p>\n <\/jats:list-item>\n \n Early recognition of hypertriglyceridaemia is essential to prevent complications such as neuropathy. Acute management may involve insulin\u2013dextrose infusion in cases of severe elevation, while long-term treatment includes fibrates, omega-3 fatty acids, and dietary modifications.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>","DOI":"10.1530\/edm-25-0060","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T11:00:58Z","timestamp":1753182058000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["Severe hypertriglyceridaemia with length-related small fibre sensory neuropathy as a complication of previous gestational diabetes mellitus"],"prefix":"10.1530","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9210-8028","authenticated-orcid":true,"given":"Fatima","family":"Iqbal","sequence":"first","affiliation":[{"name":"Department of General Medicine and Endocrinology, Ryde Hospital, Eastwood, New South Wales, Australia"},{"name":"College of Medicine, Alfaisal University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Ryde Hospital, Eastwood, New South Wales, Australia"},{"name":"School of Medicine, University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruby","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ryde Hospital, Eastwood, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akhil","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ryde Hospital, Eastwood, New South Wales, Australia"},{"name":"Western Sydney University, Blacktown Clinical School and Macarthur Clinical School, Sydney, New South Wales, Australia"},{"name":"Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of General Medicine and Endocrinology, Ryde Hospital, Eastwood, New South Wales, Australia"},{"name":"Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimalie","family":"Perera","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"},{"name":"Department of Chemical Pathology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"},{"name":"Sydney Medical School and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Dyslipidemia. [Online]","author":"Pappan N","year":"2024","unstructured":"Pappan N\n & \nRehman A\n\n. Dyslipidemia. [Online], 2024. (https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560891\/)"},{"key":"bib2","series-title":"Diabetes Care","first-page":"2285","article-title":"Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments","volume":"33","author":"Tesfaye S","year":"2010","unstructured":"Tesfaye S\n, \nBoulton AJ\n, \nDyck PJ\n, et al.\n Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 2010 33 2285\u20132293. (https:\/\/doi.org\/10.2337\/dc10-1303)"},{"key":"bib3","series-title":"J Clin Med","article-title":"Hypertriglyceridemia in gestational diabetes: case report and review of the literature","volume":"29","author":"Newman C","year":"2023","unstructured":"Newman C\n, \nGriffin D\n, \nTrulea A\n, et al.\n Hypertriglyceridemia in gestational diabetes: case report and review of the literature. J Clin Med 2023 29 100149. (https:\/\/doi.org\/10.1016\/j.jocd.2023.07.001)"},{"key":"bib4","series-title":"J Clin Lipidol","first-page":"129","article-title":"The role of hypertriglyceridemia in the development of neuropathy","volume":"8","author":"Buchholz JN","year":"2014","unstructured":"Buchholz JN\n\n. The role of hypertriglyceridemia in the development of neuropathy. J Clin Lipidol 2014 8 129\u2013138. (https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2014\/579242)"},{"key":"bib5","series-title":"JAMA","first-page":"1377","article-title":"Distal symmetric polyneuropathy: a review","volume":"324","author":"Callaghan BC","year":"2020","unstructured":"Callaghan BC\n, \nPrice RS\n & \nFeldman EL\n\n. Distal symmetric polyneuropathy: a review. JAMA 2020 324 1377\u20131385. (https:\/\/doi.org\/10.1001\/jama.2020.0700)"},{"key":"bib6","series-title":"J Diabetes Complicat","first-page":"436","article-title":"Obesity and hyperlipidemia are risk factors for early diabetic neuropathy","volume":"27","author":"Smith AG","year":"2013","unstructured":"Smith AG\n & \nSingleton JR\n\n. Obesity and hyperlipidemia are risk factors for early diabetic neuropathy. J Diabetes Complicat 2013 27 436\u2013442. (https:\/\/doi.org\/10.1016\/j.jdiacomp.2013.04.003)"},{"key":"bib7","series-title":"Am J Epidemiol","first-page":"1028","article-title":"Long-term plasma lipid changes associated with a first birth: the coronary artery risk development in young adults study","volume":"159","author":"Gunderson EP","year":"2004","unstructured":"Gunderson EP\n, \nLewis CE\n, \nMurtaugh MA\n, et al.\n Long-term plasma lipid changes associated with a first birth: the coronary artery risk development in young adults study. Am J Epidemiol 2004 159 1028\u20131039. (https:\/\/doi.org\/10.1093\/aje\/kwh146)"},{"key":"bib8","series-title":"Curr Opin Lipidol","first-page":"249","article-title":"Lipids and peripheral neuropathy","volume":"32","author":"Iqbal Z","year":"2021","unstructured":"Iqbal Z\n, \nBashir B\n, \nFerdousi M\n, et al.\n Lipids and peripheral neuropathy. Curr Opin Lipidol 2021 32 249\u2013257. (https:\/\/doi.org\/10.1097\/MOL.0000000000000770)"},{"key":"bib9","series-title":"All Tests|Sonic Genetics. [Online]","author":"Sonicgenetics.com.au","year":"2019","unstructured":"Sonicgenetics.com.au\n. All Tests|Sonic Genetics. [Online], 2019. (https:\/\/www.sonicgenetics.com.au\/our-tests\/all-our-tests\/familial-hypercholesterolaemia-fh\/)"}],"container-title":["Endocrinology, Diabetes & Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2025\/3\/EDM-25-0060.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2025\/3\/EDM-25-0060.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2025\/3\/EDM-25-0060.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:48:37Z","timestamp":1784555317000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3833"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":9,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.1530\/edm-25-0060","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]}}}