Title: Risk factors for diabetic ketoacidosis in acute pancreatitis patients with type 2 diabetes
Version: 3 Date: 23 Apr 2023
Reviewer's report:
Despite the manuscript entitled "Risk factors for diabetic ketoacidosis in acute pancreatitis
patients with type 2 diabetes" sound scientific enough, there are few issues that must be revised
before consideration.
- Rationale of the study must be issued better in the background. Acute pancreatitis
is associated with elevation inflammatory markers (National Journal of Health Sciences
2021;6(3):90-91. DOI: 10.21089/njhs.63.0090) and cytokines (Rev Assoc Med Bras (1992).
2019 Feb;65(2):204-210. doi: 10.1590/1806-9282.65.2.204). Similarly, diabetes mellitus (Acta
Medica Mediterranea 2014;30:425-428) and its complications (Primary Care Diabetes, 2021;
15(6): 1071-1074.   DOI: 10.1016/j.pcd.2021.08.015.) are characterized with high burden of
inflammation. Hence studying diabetic ketoacidosis in acute pancreatitis patients is reasonable.
Improve the introduction section please.
- Small study cohort is the main methodological issue. However, methods were expressed well,
otherwise. Statistics are correct except lack of mentioning of the normality test that conducted
with to the study variables.
- Discussion is too short. Main aspects for a discussion were ignored. For example, authors
found serum uric acid as a risk factor for development of DKA. DKA is associated with
increased markers of inflammation. Similarly, high serum uric acid or uric acid based markers
were reported in other inflammatory conditions including hypertension (Postgraduate Medicine
2022;134(3): 297-302. DOI: 10.1080/00325481.2022.2039007), hepatic steatosis (Rev Assoc
Med Bras 2021;67(4):549-554. DOI: 10.1590/1806-9282.20201005.), thyroiditis (Rom. J.
Intern. Med. 2021;59(4):403-408. DOI: 10.2478/rjim-2021-0023.), metabolic syndrome (Rev
Assoc Med Bras 2019; 65(1):9-15.  DOI: 10.1590/1806-9282.65.1.9) and type 2 DM
(Aging Male. 2020;23(5):1098-1102. DOI: 10.1080/13685538.2019.1678126). In addition, I
recommend authors to comment on clinical usage of their findings even with few words. Finally,
single center nature could be added as another limitation.
Title: Risk factors for diabetic ketoacidosis in acute pancreatitis patients with type 2 diabetes
Version: 3 Date: 23 Apr 2023
Reviewer's report:
Despite the manuscript entitled "Risk factors for diabetic ketoacidosis in acute pancreatitis
patients with type 2 diabetes" sound scientific enough, there are few issues that must be revised
before consideration.
- Rationale of the study must be issued better in the background. Acute pancreatitis
is associated with elevation inflammatory markers (National Journal of Health Sciences
2021;6(3):90-91. DOI: 10.21089/njhs.63.0090) and cytokines (Rev Assoc Med Bras (1992).
2019 Feb;65(2):204-210. doi: 10.1590/1806-9282.65.2.204). Similarly, diabetes mellitus (Acta
Medica Mediterranea 2014;30:425-428) and its complications (Primary Care Diabetes, 2021;
15(6): 1071-1074.   DOI: 10.1016/j.pcd.2021.08.015.) are characterized with high burden of
inflammation. Hence studying diabetic ketoacidosis in acute pancreatitis patients is reasonable.
Improve the introduction section please.
- Small study cohort is the main methodological issue. However, methods were expressed well,
otherwise. Statistics are correct except lack of mentioning of the normality test that conducted
with to the study variables.
- Discussion is too short. Main aspects for a discussion were ignored. For example, authors
found serum uric acid as a risk factor for development of DKA. DKA is associated with
increased markers of inflammation. Similarly, high serum uric acid or uric acid based markers
were reported in other inflammatory conditions including hypertension (Postgraduate Medicine
2022;134(3): 297-302. DOI: 10.1080/00325481.2022.2039007), hepatic steatosis (Rev Assoc
Med Bras 2021;67(4):549-554. DOI: 10.1590/1806-9282.20201005.), thyroiditis (Rom. J.
Intern. Med. 2021;59(4):403-408. DOI: 10.2478/rjim-2021-0023.), metabolic syndrome (Rev
Assoc Med Bras 2019; 65(1):9-15.  DOI: 10.1590/1806-9282.65.1.9) and type 2 DM
(Aging Male. 2020;23(5):1098-1102. DOI: 10.1080/13685538.2019.1678126). In addition, I
recommend authors to comment on clinical usage of their findings even with few words. Finally,
single center nature could be added as another limitation.
Please review this paper.
user
Title: Risk factors for diabetic ketoacidosis in acute pancreatitis patients with type 2 diabetes
Version: 3 Date: 23 Apr 2023
Reviewer's report:
Despite the manuscript entitled "Risk factors for diabetic ketoacidosis in acute pancreatitis
patients with type 2 diabetes" sound scientific enough, there are few issues that must be revised
before consideration.
- Rationale of the study must be issued better in the background. Acute pancreatitis
is associated with elevation inflammatory markers (National Journal of Health Sciences
2021;6(3):90-91. DOI: 10.21089/njhs.63.0090) and cytokines (Rev Assoc Med Bras (1992).
2019 Feb;65(2):204-210. doi: 10.1590/1806-9282.65.2.204). Similarly, diabetes mellitus (Acta
Medica Mediterranea 2014;30:425-428) and its complications (Primary Care Diabetes, 2021;
15(6): 1071-1074.   DOI: 10.1016/j.pcd.2021.08.015.) are characterized with high burden of
inflammation. Hence studying diabetic ketoacidosis in acute pancreatitis patients is reasonable.
Improve the introduction section please.
- Small study cohort is the main methodological issue. However, methods were expressed well,
otherwise. Statistics are correct except lack of mentioning of the normality test that conducted
with to the study variables.
- Discussion is too short. Main aspects for a discussion were ignored. For example, authors
found serum uric acid as a risk factor for development of DKA. DKA is associated with
increased markers of inflammation. Similarly, high serum uric acid or uric acid based markers
were reported in other inflammatory conditions including hypertension (Postgraduate Medicine
2022;134(3): 297-302. DOI: 10.1080/00325481.2022.2039007), hepatic steatosis (Rev Assoc
Med Bras 2021;67(4):549-554. DOI: 10.1590/1806-9282.20201005.), thyroiditis (Rom. J.
Intern. Med. 2021;59(4):403-408. DOI: 10.2478/rjim-2021-0023.), metabolic syndrome (Rev
Assoc Med Bras 2019; 65(1):9-15.  DOI: 10.1590/1806-9282.65.1.9) and type 2 DM
(Aging Male. 2020;23(5):1098-1102. DOI: 10.1080/13685538.2019.1678126). In addition, I
recommend authors to comment on clinical usage of their findings even with few words. Finally,
single center nature could be added as another limitation.
assistant