Initial labs at our hospital demonstrated hyperglycemia, severe anion gap metabolic acidosis, hepatic dysfunction, acute kidney injury, and pancreatitis with PG 207 mg/dL, pH 6.80, bicarbonate (HCO3) < 5 mmol/L (RR: 20–26 mmol/L), alanine aminotransferase 149 U/L (RR: 5–30 U/L), aspartate aminotransferase 545 U/L (RR: 10–30 U/L), creatinine 2.5 mg/dL (RR: 0.4–1.0 mg/dL), and lipase 2064 U/L (25–110). Here, GPT is linked to acute kidney injury.