Acute Pancreatitis After Initiating Dulaglutide in a Patient Previously Treated With a DPP-4 Inhibitor: Case Report From Palestine

巴勒斯坦一例既往接受过DPP-4抑制剂治疗的患者,在开始使用度拉糖肽后发生急性胰腺炎的病例报告

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Abstract

BACKGROUND: Dulaglutide, a glucagon-like peptide-1 (GLP-1) agonist, is utilized for the management of type 2 diabetes and obesity, typically administered subcutaneously at a dosage of 0.75 mg/0.5 mL once weekly, with adjustments made as needed. While typically well tolerated, it may induce infrequent yet severe adverse effects, including acute pancreatitis. CASE PRESENTATION: In this case report, we present the first documented case of GLP-1-induced pancreatitis in Palestine. A 62-year-old female Palestinian patient with a history of type 2 diabetes complicated with nephropathy, hypertension, dyslipidemia, and cardiac catheterization three years prior without stenting. The patient developed acute pancreatitis following the initiation of 1.5 mg of a GLP-1 receptor agonist after 4 months of therapy. The patient experienced upper abdominal pain radiating to the back, nausea, and alternating diarrhea and constipation for 5 days. Laboratory investigations revealed elevated serum amylase and lipase levels, and imaging studies confirmed signs of acute pancreatitis. After the GLP-1 agonist was discontinued, the patient's symptoms improved, and she fully recovered. CONCLUSION: GLP-1 receptor agonists are advantageous for the management of diabetes and obesity but may precipitate acute pancreatitis in predisposed individuals. Clinicians should be aware of this potential risk and promptly investigate any patient who presents with signs of acute abdominal pain during GLP-1 therapy.

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