title: Clinical course of diabetic ketoacidosis in hypertriglyceridemic pancreatitis.
abstract: OBJECTIVE
  Hypertriglyceridemic pancreatitis (HP) is an uncommon condition accounting for 1% to 4% of cases of acute pancreatitis, mostly associated with poor glycemic control. Diabetic ketoacidosis (DKA) may complicate the clinical course of HP. Our objective was to identify clinical and demographic differences between HP and DKA patients compared with those without DKA.
  
  
  METHODS
  Fifty-five patients with HP were included. Diabetic ketoacidosis was diagnosed in 8 patients. We analyzed the severity, hospital stay, delay in oral intake, duration of insulin infusion, complete blood cell count, and triglyceride levels.
  
  
  RESULTS
  Diabetic ketoacidosis was associated with a more severe HP. There were no differences in hospital stay, delay in oral intake, or duration of insulin treatment in both groups. Serum amylase, lipase, and triglyceride levels were similar. Previous diagnosis of diabetes mellitus, higher Ranson and APACHE II scores, and higher serum glucose level at admission were the only predictive risk factors for DKA and HP.
  
  
  CONCLUSIONS
  Coexistence of DKA does not modify the clinical course of HP, although a more severe episode of HP in DKA patients. Diabetic ketoacidosis was associated with higher insulin doses, without impact in triglyceride levels. Diabetic ketoacidosis and HP should be considered when a previous diagnosis of diabetes mellitus and a severe HP are present.
authors.affiliation: From the *Department of Internal Medicine, Dr José Eleuterio González University Hospital, †School of Medicine, ‡Endocrinology Division, Dr José Eleuterio González University Hospital, and §Research Division, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
authors.forename: Dania Lizet
authors.initials: DL
authors.lastname: Quintanilla-Flores
authors.forename: Erick Joel
authors.initials: EJ
authors.lastname: Rendón-Ramírez
authors.forename: Perla Rocío
authors.initials: PR
authors.lastname: Colunga-Pedraza
authors.forename: Jesús
authors.initials: J
authors.lastname: Gallardo-Escamilla
authors.forename: Sergio Antonio
authors.initials: SA
authors.lastname: Corral-Benavides
authors.forename: José Gerardo
authors.initials: JG
authors.lastname: González-González
authors.forename: Héctor Eloy
authors.initials: HE
authors.lastname: Tamez-Pérez
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D016883:Diabetic Ketoacidosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult