Q. A 35-year-old female with a past medical history of obesity and gestational diabetes presents to the emergency department with severe abdominal pain. The pain is constant, located in the epigastric region, and radiates to the back. She reports nausea and vomiting, which worsened the pain. Physical examination reveals a positive Cullen's sign and Grey-Turner's sign. Laboratory evaluation shows a significant elevation of serum triglyceride levels, greater than 1000 mg/dL. The patient's blood glucose levels and HbA1c are also elevated. What is the most likely cause of this patient's hypertriglyceridemia?