SELF-MONITORING OF TRIGLYCERIDES BY TYPE-2 DIABETIC-PATIENTS - VARIABILITY IN FASTING AND POSTPRANDIAL LEVELS

Triglycerides are an important risk factor for coronary heart disease in Type 2 (noninsulin-dependent) diabetes mellitus. Although Type 2 di abetic patients have an exaggerated postprandial triglyceride response to a fat meal test, little is known about the variability of triglyce ride concentrations in day-to-day life. We have studied the variabilit y in triglyceride concentrations in 24 Type 2 diabetic patients over 6 months by having them record fasting and postprandial triglyceride co ncentrations at home using a Reflotron dry chemistry analyser. All pat ients were able to use the analyser effectively, with a correlation of 0.97 between patients' monthly Reflotron readings and those recorded by the laboratory. Over 1600 measurements were performed. The results demonstrate a large variation in both fasting (median 1.95 mmol l(-1), range 0.8-6.7 mmol l(-1)) and postprandial triglyceride concentration s (median 2.68 mmol l(-1), range 0.8-6.7 mmol l(-1)). This variation w as accounted for by both a large intra- and inter-individual variation . Although there was a strong correlation overall between fasting and postprandial triglyceride concentrations large variability in triglyce ride concentrations should be considered before introducing pharmacolo gical therapy for hypertriglyceridaemia in Type 2 diabetes mellitus.