Significance of Hyperamylasaemia and Abdominal Pain in Diabetic Ketoacidosis

An analysis of 35 consecutive episodes of diabetic ketoacidosis confirmed the frequent high levels of serum amylase in this condition. Serum amylase was raised during 21 episodes (60%), and in six instances (17%) the peak level exceeded 1,000 Somogyi units per 100 ml. Hyperamylasaemia was more often found when the initial blood sugar exceeded 500 mg/100 ml, or when the onset of the episode had been relatively acute (less than 48 hours). There was no conclusive evidence in any patient to support a diagnosis of acute pancreatitis and other explanations for the hyperamylasaemia are discussed. Even grossly raised amylase levels were not associated with increased mortality or morbidity.