06 January 2026
: Case report 
Diabetic Ketoacidosis Unveiling Severe Hypertriglyceridemia and Acute Mild Pancreatitis: A Rare Initial Manifestation of Type 2 Diabetes Mellitus
Rare coexistence of disease or pathology
Parth Adrejiya
AEFG 1*, Sunil Shahi F 1, Abdullah Lodhi EF 1, Mohammad Abubaker E 1, Jill Vora EF 2, Gurkeerat Singh FG 3, Cyril Anara AG 1, Swathi Gorle AG 1, Ashok Kanugula EFG 1
DOI: 10.12659/AJCR.950094
Am J Case Rep 2026; 27:e950094
Figure 3 Insulin deficiency promotes uncontrolled lipolysis via hormone-sensitive lipase, increasing free fatty acids and hepatic VLDL production. Impaired lipoprotein lipase activity and reduced peripheral lipid uptake elevate serum TG levels, predisposing patients to acute pancreatitis. Additional risk factors include alcohol use, genetic lipid disorders, and enzyme deficiencies. DKA – diabetic ketoacidosis; IDL – intermediate-density lipoprotein; LDL – low-density lipoprotein; TG – triglyceride; VLDL – very low-density lipoprotein.