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In his comments, Dr Whayne notes that the patient described was treated with intravenous insulin in addition to intravenous UFH in an attempt to prevent the development of HTG-associated acute pancreatitis and that insulin itself has LPL-enhancing activity. While both agents were eventually administered, only insulin was given for the first 21 hours, during which the serum triglyceride concentration decreased only 4.6% from baseline.
Cole RP. Concerns About Heparin Therapy for Hypertriglyceridemia—Reply. Arch Intern Med. 2010;170(1):109. doi:10.1001/archinternmed.2009.462