Lipemia retinalis is a rare retinal finding of hypertriglyceridemia. We report a case of secondary hyperlipoproteinemia in a 24-year-old patient with type 2 diabetes who presented with excessive thirst, polyuria and an extremely high serum triglyceride level (9,100 mg/dL). The hypertriglyceridemia was improved after intensive insulin therapy and lipid-lowering agents. This case is a reminder of the need for clinical awareness of severe hypertriglyceridemia, a life threatening metabolic disorder, in patients with poor glycemic control.