To the Editor.—
In their article on prolonged high blood amylase levels in a case of diabetic ketoacidosis, Drs vanSonnenberg and Pitchumoni discuss a possible causal connection between diabetes and pancreatitis.Since they refer to Somogyi's pioneer work on low serum amylase levels in diabetic ketoacidosis, it may be of more than historic interest that this puzzling altered amylase level in diabetes had intrigued the investigator as early as 1929.1 At that time it was already known that, in experimental as well as clinical nonketotic diabetes, urinary amylase values can be low. This was explained by diminished renal filtration. Perhaps vanSonnenberg and Pitchumoni, as clinicians, can take comfort in the fact that, in the experimental phlorizin diabetes of the rabbit, the increase in urine amylase had then also been found to be "oddly protracted."
Schmerl EF. Blood Amylase and Diabetic Ketoacidosis. JAMA. 1977;237(6):532. doi:10.1001/jama.1977.03270330022011
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