Serum Amylase and Lipase in Diabetic Ketoacidosis

  1. Ali A. Rizvi, MD
  1. From the Medical College of Georgia, Augusta, Georgia
  1. Address correspondence to Ali A. Rizvi, 820 Saint Sebastian Way, Suite 7A, Augusta, GA 30901. E-mail: aarizvi{at}

Increased amylase and lipase occurs 16–25% of the time in diabetic ketoacidosis (DKA) (1). Acute pancreatitis can present or coexist with DKA and aggravate its severity (2). Nonspecific elevations of amylase in DKA have been reported (3), although increased serum lipase is assumed to indicate actual pancreatic involvement. Two cases of DKA are described in which elevated enzymes were seen without clinical or radiographic evidence of acute pancreatitis.

The first patient was a 74-year-old female with a 32-year history of type 1 diabetes who presented with DKA. Although she had no abdominal pain or tenderness, her amylase and lipase levels were elevated and peaked at values of 1,024 units/l (normal range 17–100 units/l) and 3,455 units/l (normal range <53 …

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