Diabetic ketoacidosis, severe hypertriglyceridemia, and acute pancreatitis in type 2 diabetes mellitus: a two-patient case series
Authors:
Eleni Tzouveli
, Antonia Syriha
, Petros Kouzanidis
, Despoina Gyriki
, Maria-Stella Malatesta
, Ioannis Elefsiniotis
Abstract
The coexistence of diabetic ketoacidosis (DKA) complicated by severe hypertriglyceridemia and acute pancreatitis is a rare, but
a life-threatening condition that poses considerable diagnostic and management difficulties. In this case series, we describe two
cases of young men with type 2 diabetes mellitus (T2D) with profound DKA, marked hypertriglyceridemia, and acute pancreatitis.
Intensive treatment with intravenous insulin, aggressive fluid replacement, and supportive measures led to rapid resolution of
ketoacidosis, substantial reduction in triglyceride levels, and clinical improvement. These cases highlight the intricate metabolic
relationship between insulin deficiency, severe hypertriglyceridemia, and pancreatic injury in T2DM, emphasizing the importance
of early recognition, insulin-based management, and close metabolic follow-up to guide long-term glycemic and lipid control.
Keywords: Diabetic ketoacidosis, severe hypertriglyceridemia, acute pancreatitis, insulin treatment, case series.
Pubmed Style
Eleni Tzouveli, Antonia Syriha, Petros Kouzanidis, Despoina Gyriki, Maria-Stella Malatesta, Ioannis Elefsiniotis. Diabetic ketoacidosis, severe hypertriglyceridemia, and acute pancreatitis in type 2 diabetes mellitus: a two-patient case series. EJMCR. 2026; 05 (August 2026): -. doi:10.24911/ejmcr.9-2939
Publication History
Received: June 08, 2026
Revised: July 07, 2026
Accepted: July 15, 2026
Published: August 05, 2026
Authors
Eleni Tzouveli
Academic Department of Internal MedicineHepatogastroenterology Unit, General Oncology Hospital of Kifisia “Agioi Anargyroi”, National and Kapodistrian University of Athens, Kifisia, Greece.
Antonia Syriha
Academic Department of Internal MedicineHepatogastroenterology Unit, General Oncology Hospital of Kifisia “Agioi Anargyroi”, National and Kapodistrian University of Athens, Kifisia, Greece.
Petros Kouzanidis
Academic Department of Internal MedicineHepatogastroenterology Unit, General Oncology Hospital of Kifisia “Agioi Anargyroi”, National and Kapodistrian University of Athens, Kifisia, Greece.
Despoina Gyriki
Academic Department of Internal MedicineHepatogastroenterology Unit, General Oncology Hospital of Kifisia “Agioi Anargyroi”, National and Kapodistrian University of Athens, Kifisia, Greece.
Maria-Stella Malatesta
Academic Department of Internal MedicineHepatogastroenterology Unit, General Oncology Hospital of Kifisia “Agioi Anargyroi”, National and Kapodistrian University of Athens, Kifisia, Greece.
Ioannis Elefsiniotis
Academic Department of Internal MedicineHepatogastroenterology Unit, General Oncology Hospital of Kifisia “Agioi Anargyroi”, National and Kapodistrian University of Athens, Kifisia, Greece.