Elevated serum lipase is not associated with DKA. It is specific to acute pancreatitis. DKA has a similar presentation like acute pancreatitis with abdominal pain, hyperglycemia, and elevated serum amylase. Serum lipase can differentiate both. Differential diagnosis of acute pancreatitis Biliary colic Acute cholecystitis Perforated hollow viscus (e.g., perforated peptic ulcer) Mesenteric ischemia or infarction Intestinal obstruction Myocardial infarction Dissecting aoic aneurysm Ectopic pregnancy