Elevation of Serum Lipase during Diabetic Ketoacidosis: What are the Interpretations?

Neima HASSAN ADEN; S. Rafi; S. Ijdda; G. El Mghari

doi:10.36948/ijfmr.2026.v08i02.73468

Elevation of Serum Lipase during Diabetic Ketoacidosis: What are the Interpretations?

Author(s)	Dr. Neima HASSAN ADEN, S. Rafi, S. Ijdda, G. El Mghari
Country	Morocco
Abstract	Abstract: Background: Diabetic ketoacidosis (DKA) is a life-threatening metabolic complication of diabetes mellitus and may be associated with elevated pancreatic enzymes, complicating the diagnosis of acute pancreatitis. The interpretation of hyperlipasemia in DKA remains challenging, as it may occur without true pancreatic injury. This study aimed to investigate the association between DKA and acute pancreatitis and to evaluate severity using the Ranson score. Methods: We conducted a prospective observational study including 75 adult patients admitted for DKA at the Department of Endocrinology and Metabolic Diseases, CHU Mohamed VI, Marrakech, over a one-year period. Clinical, biological, and radiological data were collected. The severity of pancreatitis was assessed using the Ranson score, and statistical analysis was performed using SPSS and JAMOVI software. Results: The mean age of patients was 45 years, with a slight female predominance (sex ratio 0.7). DKA revealed newly diagnosed diabetes in 34 cases and was associated mainly with type 1 diabetes (33 cases). Hypertriglyceridemia was present in 52% of patients, and serum lipase was elevated in the majority. CT imaging showed predominantly mild to moderate pancreatitis (46.7% stage A, 49.3% stage C, and 4% stage E). A strong association was found between admission pH, radiological stage, and high Ranson score (p < 0.001). Hypertriglyceridemia was significantly correlated with elevated lipase levels (p < 0.001), whereas no association was found between lipase levels and the Ranson score. Clinical outcomes were favorable in most cases, with only one death reported. Conclusion: Hyperlipasemia and hypertriglyceridemia are common in DKA and may mimic or coexist with acute pancreatitis. However, elevated lipase alone is not sufficient for diagnosis. A combined approach including clinical assessment, biochemical markers, and imaging is essential for accurate diagnosis and management. Early and appropriate treatment of DKA leads to favorable outcomes and reduces complications.
Keywords	Keywords: Diabetic ketoacidosis; Acute pancreatitis; Hyperlipasemia; Hypertriglyceridemia; Ranson score; Diabetes mellitus; Computed tomography; Metabolic complications
Field	Médical / Pharmacie
Published In	Volume 8, Issue 2, March-April 2026
Published On	2026-04-10
DOI	https://doi.org/10.36948/ijfmr.2026.v08i02.73468

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Elevation of Serum Lipase during Diabetic Ketoacidosis: What are the Interpretations?

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