A difficult case. Childhood onset insulin dependent diabetes presenting with severe hyperlipidaemia.

Confronted with a child deteriorating during treatment of diabetic ketoacidosis, Godfrey Nyamugunduru and Helen Roper describe how the child's management was complicated by gross hyperlipidaemia. At the point where the child's condition was deteriorating despite conventional management we invited two experts-Gilbert R Thompson and J I Mann-to suggest a course of action. The original authors then describe how they did manage the case, and our experts comment again.