Incretin-Based Therapies and Pancreatitis Risk

Introduction to Incretin-Based Therapies

The American Diabetes Association and European Association for the Study of Diabetes note that concerns regarding an increased risk of pancreatitis with incretin-based therapies, including DPP-4 inhibitors and GLP-1 receptor agonists, remain unresolved in diabetic patients 1, 2, 3
The American Diabetes Association and European Association for the Study of Diabetes guidelines state that nausea and vomiting are limiting side effects of GLP-1 receptor agonists, particularly early in treatment, and that concerns regarding an increased risk of pancreatitis remain unresolved in patients with diabetes 1, 2, 3

Incretin-based therapies, including DPP-4 inhibitors and GLP-1 receptor agonists, should be used with caution in patients with pancreatic disease, such as type 3c diabetes, as they have been rarely reported to be associated with pancreatitis 4
The guidelines recommend avoiding incretin-based therapies in patients with active pancreatitis or a recent episode, as it is an absolute contraindication 4
In patients with type 3c diabetes, incretin-based therapies should be used with extreme caution only if other options are unsuitable, and patients should be monitored closely for signs of pancreatitis 4
DPP-4 inhibitors and GLP-1 receptor agonists should be avoided in patients with elevated lipase without pancreatitis, as it may indicate an increased risk of pancreatitis 4