Case Presentation: 44-year-old male with past medical history of diabetes mellites, hypertension, pancreatitis and hypertriglyceridemia presented to the ED with acute abdominal pain and vomiting. Physical examination was unremarkable other than epigastric tenderness and elevated BMI of 33. Chemistry revealed glucose: 259 mg/dL, bicarbonate: 20 mmol/L, anion gap 19, lipase 1170 U/L, WBC count 15.6K/cc, [...]