A 23-year-old man lost control of his blood sugar, his triglycerides soared past 6,000, and he developed xanthomas on his back.

2026/09/23 13:22

Metabolic physician Yang Youlin pointed out that due to poor blood sugar control, the 23-year-old man's triglycerides soared past 6,000 and his back was covered with "xanthomas." (Photo courtesy of physician Yang Youlin)

[Health Channel/Comprehensive Report] High blood sugar not only brings the risk of diabetes, but may also lead to more health threats. Metabolic physician Yang Youlin shared that a 23-year-old male with diabetes developed xanthomas (or xanthomas) all over his back due to poor blood sugar control. After a blood test, it was found that the triglyceride (TG) value soared past 6000mg/dL and reached 6214mg/dL. Fortunately, after a low-fat diet, strict blood sugar control, and increased insulin dose adjustment and treatment, the xanthomas on the back skin became smaller and improved after a follow-up visit one month later.

Yang Youlin posted on the Facebook fan page "Dr. Yang Youlin" that the cause of eruptive xanthoma is usually when TG exceeds 2000mg/dL, resulting in the formation of small, hard and waxy protrusions on the skin. They are generally about 1-4 mm in size, have a shiny surface, may be yellow, pink or red in color, and are often surrounded by redness. They usually appear on the back, buttocks, shoulders, arms, and thighs; they are not painful but can sometimes be itchy or tender.

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Yang Youlin further explained that people with absolute or relative insulin deficiency, such as patients with type 2 diabetes who have extremely poor control, may not only cause hyperglycemia, hyperglycemic symptoms, and even hyperglycemic crisis, but also reduce lipoprotein lipase (#LPL) activity. It may also cause systemic fat metabolism disorders, leading to extreme increases in TG, sometimes even soaring to more than 2000-5000 mg/dL, increases in very low-density cholesterol (VLDL), and decreases in high-density cholesterol (HDL), increasing the risk of arteriosclerosis and heart disease.

Yang Youlin said that hypertriglyceridemia is related to fatty liver. Ectopic fat causes chronic inflammation, which in turn increases insulin resistance and can easily induce pancreatitis. In severe cases, it may even cause pancreatic necrosis, sepsis, and shock.

To avoid the occurrence of xanthomas, Yang Youlin reminded that you should master the principles of a low triglyceride diet every day, including: quit smoking, drink less alcohol, avoid sugar and sugar substitutes, reduce fructose, refined starches and processed foods, and eat more fish and dietary fiber. In addition, you should exercise more, control your total calories in your diet, and maintain your ideal weight.