Several mechanisms were proposed in this study including: (1) chronic hyperglycemia leads to increased reactive oxygen species, increased lipid peroxidase which may lead to AP episodes; (2) association with comorbid conditions such as obesity, hyperlipidemia, and gallstones which can precipitate AP; (3) cellular mechanisms including enhanced ryanodine receptor function leading to alterations in cellular mechanisms, specifically calcium and is a similar pathway involved in AP and DM [24].