Diabetic ketoacidosis (DKA) is a life threatening acute complication of type 1 diabetes. Since diabetic patients may have hypertriglyceridemia, they are at risk of developing acute pancreatitis (AP). Hyperamylasemia may suggest a diagnosis of AP, but levels may be elevated in DKA. Hence, serum lipase levels correlate better with the diagnosis of AP. However, pancreatic enzymes are excreted by the kidneys and their levels are elevated in patients with chronic kidney disease (CKD). This report describes a patient with type 1 diabetes and CKD stage 4, not on hemodialysis, who presented with DKA and had very high levels of pancreatic enzymes in the absence of pancreatitis.