We report a 59-year-old man with diabetic lipemia associated with acute pancreatitis. The patient was being treated for type 2 diabetes, but his glycemic control was poor. Although his insulin secretory activity was preserved, acute pancreatitis developed because of hypertriglyceridemia and the patient had type V hyperlipidemia. After hospitalization, his hyperlipidemia and hyperglycemia improved in response to insulin infusion and hydration. It is well known that diabetic lipemia is caused by type 1 diabetes, but is rare in type 2 diabetes. Insulin resistance, as well as insulin deficiency, might play a role in the development of diabetic lipemia.