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We thank Dr Berk for his comments. However, as emphasized in our discussion and in prior reports, patients with hyperamylasemia treated for acute diabetic ketoacidosis returned to their baseline amylase values within three to four days. Clearly, the patient described in our article with serum amylase levels of 1,015 Caraway units (day 4), 649 Caraway units (day 6), and 625 Caraway units (day 8) had not reached her recorded "baseline" of 310 Caraway units in the typical time period. Indeed, it is speculative even to suppose a baseline as high as 310 Caraway units; the patient never visited the hospital in a nonacute clinical state and a true baseline amylase value could not be obtained.It is interesting that the patient described by Drs Block and Berk, with documented macroamylasemia and diabetic ketoacidosis, also typically reverted to baseline values by days 4, 6, and 8 (by line graph—no
vanSonnenberg E, Pitchumoni CS. Blood Amylase and Diabetic Ketoacidosis-Reply. JAMA. 1977;237(6):532. doi:10.1001/jama.1977.03270330022012
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