In patients with a history of pancreatitis who also have diabetes, which diabetes medications should be avoided or used with caution?

In patients with a history of pancreatitis who also have diabetes, which diabetes medications should be avoided or used with caution?

• A. Sitagliptin
• B. Liraglutide
• C. Both
• D. Neither

Answer: (C)

In patients with a history of pancreatitis, the choice of diabetes meds should avoid agents with potential to provoke pancreatic inflammation. Sitagliptin, a DPP-4 inhibitor, and liraglutide, a GLP-1 receptor agonist, are both incretin-based therapies that have been associated with reports of pancreatitis and carry warnings in their labeling. Because pancreatitis can recur or be triggered by these drugs, they are best avoided or used with caution in someone who has had pancreatitis. If such therapy is considered, close monitoring for new or worsening abdominal pain and pancreatitis symptoms is essential, and discontinuation should be prompt if pancreatitis is suspected. In contrast, other diabetes medications without this association—such as metformin in appropriate patients or insulin when needed—are often preferred first in this context.

In patients with a history of pancreatitis, the choice of diabetes meds should avoid agents with potential to provoke pancreatic inflammation. Sitagliptin, a DPP-4 inhibitor, and liraglutide, a GLP-1 receptor agonist, are both incretin-based therapies that have been associated with reports of pancreatitis and carry warnings in their labeling. Because pancreatitis can recur or be triggered by these drugs, they are best avoided or used with caution in someone who has had pancreatitis. If such therapy is considered, close monitoring for new or worsening abdominal pain and pancreatitis symptoms is essential, and discontinuation should be prompt if pancreatitis is suspected. In contrast, other diabetes medications without this association—such as metformin in appropriate patients or insulin when needed—are often preferred first in this context.