Mansour Amirpasha, Ghasemzade Shima
Department of Anesthesiology and Pain Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Internal Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
Clin Med Insights Endocrinol Diabetes. 2025 Feb 27;18:11795514251323826. doi: 10.1177/11795514251323826. eCollection 2025.
Diabetic ketoacidosis (DKA) is an acute complication of diabetes that mainly occurs in type 1 diabetes. However, it can also occur in type 2 diabetes, although less commonly. One of the rare causes of this condition is acute pancreatitis. While hypertriglyceridemia is a known complication of DKA, triglyceride levels higher than 2000 are an unusual finding. We present a case of undiagnosed type 2 diabetes mellitus in a patient who came to the hospital with epigastric pain, nausea, and vomiting. Subsequent blood tests revealed hyperglycemia, ketonuria, metabolic acidosis, and increased levels of amylase and lipase, leading to a simultaneous diagnosis of DKA, acute pancreatitis, and very severe hypertriglyceridemia. In patients experiencing abdominal pain and severe diabetic complications, acute pancreatitis should always be considered as a possible diagnosis, and triglyceride levels should be tested to identify hypertriglyceridemia as a potential cause of pancreatitis or complications of DKA.
糖尿病酮症酸中毒(DKA)是糖尿病的一种急性并发症,主要发生于1型糖尿病。然而,它也可发生于2型糖尿病,尽管较为少见。这种情况的罕见病因之一是急性胰腺炎。虽然高甘油三酯血症是DKA的已知并发症,但甘油三酯水平高于2000是不寻常的发现。我们报告一例未确诊的2型糖尿病患者,该患者因上腹部疼痛、恶心和呕吐前来医院就诊。随后的血液检查显示高血糖、酮尿、代谢性酸中毒以及淀粉酶和脂肪酶水平升高,从而同时诊断出DKA、急性胰腺炎和非常严重的高甘油三酯血症。对于出现腹痛和严重糖尿病并发症的患者,应始终考虑急性胰腺炎作为可能的诊断,并检测甘油三酯水平以确定高甘油三酯血症是否为胰腺炎或DKA并发症的潜在原因。