Diabetic Ketoacidosis and Hypertriglyceridemiainduced Pancreatitis: Can the Perfect Storm Happen Twice?

This case report describes the recurrence of diabetic ketoacidosis (DKA) leading to hypertriglyceridemia-induced pancreatitis. Hypertriglyceridemia is present in 2–5% of patients with diabetic ketoacidosis. Hypertriglyceridemiainduced pancreatitis occurs in up to 4% of patients with diabetic ketoacidosis and is a well-reported complication. This is the first case report to the author’s knowledge, where the same patient had two separate episodes of acute pancreatitis that have been attributed to diabetic ketoacidosis and resultant severe hypertriglyceridemia, etiology determined to be medication non-compliance. DKA and acute pancreatitis can co-exist, and hypertriglyceridemia has been the predominant pathogenetic link between the two conditions. We also describe the pathophysiology and treatment of hyper-triglyceridemia-induced pancreatitis in diabetic ketoacidosis.