Robin George Manappallil has completed his Bachelor of Medicine and Bachelor of Surgery degree from Father Muller Medical College, India and his MD in Internal Medicine from Pondicherry Institute of Medical Sciences, India. He has received three gold medals for being the highest scorer in his MD exams in college as well as university and for being the best outstanding post graduate. He has published around 15 papers in national and international journals. He is currently serving as a Consultant Physician at National Hospital, Calicut, India.


Diabetic patients are at the risk of developing acute pancreatitis, due to hypertriglyceridemia. Diabetic ketoacidosis in an acute life threatening complication of type-1 diabetes; an elevated serum amylase levels may be suggestive of acute pancreatitis, but these levels may also be elevated in diabetic ketoacidosis. In such cases, serum lipase levels aid in the diagnosis of acute pancreatitis. However, in patients with chronic kidney disease, the levels of amylase and lipase will be elevated, as the pancreatic enzymes are excreted by the kidneys. This is a case report of a young lady with type-1 diabetes and chronic kidney disease (stage 4), not on hemodialysis, who presented with diabetic ketoacidosis and had elevated levels of amylase and lipase, in the absence of pancreatitis.

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