Hyperglycemia with Ketoacidosis following Acute Necrotizing Pancreatitis: A Case Suggestive of Pancreatogenic Diabetes

ABSTRACT: A 44-year-old female, known case of hypertension and hypothyroidism, presented with severe epigastric pain and vomiting. Laboratory evaluation showed significant hyperglycemia (440 mg/dL), ketonuria, and metabolic acidosis (pH - 7.3, HCO - 10.6 mEq/L), consistent with Diabetic Ketoacidosis. Amylase and lipase levels were elevated. Imaging showed acute necrotising pancreatitis with 70%-80% necrosis (modified Computed tomography severity score inde × 8/10). The patient was shifted to the intensive care unit, where blood sugar levels and hypertension were strictly controlled. The patient was vitally stable and had shown significant clinical improvement. She was discharged on injectable insulin, oral antihypertensive and hypothyroid medication and is on regular follow-up.