Case Report of Acute Pancreatitis Associated With Combination Treatment of Dulaglutide and Glipizide

The objective of this report is to discuss a case of drug-induced acute pancreatitis in a patient on a combination of dulaglutide and glipizide. The patient was a 61-year-old African American male with a past medical history of diabetes mellitus type 2 and essential hypertension, who was admitted for acute pancreatitis after presenting with upper abdominal pain. He was initially on glipizide but dulaglutide was added to improve control. The patient was a social drinker and an ex-cigarette smoker. He had serum lipase greater than 900 U/L, serum alcohol was negative, and abdominal computed tomography reported significant pancreatic edema consistent with acute pancreatitis but without features of necrotizing pancreatitis and no evidence of cholelithiasis or choledocholithiasis. His clinical state deteriorated after being complicated by paralytic ileus. He was managed conservatively, improved clinically, and was discharged home. Seeing that the incidence of pancreatitis is higher in patients with diabetes when compared to non-diabetics, it is important to counsel and monitor patients for risk factors of pancreatitis including medications. In the absence of other common causes in this case and considering the temporal relationship between presentation and the addition of dulaglutide to ongoing glipizide regimen, the combination of both drugs may have induced acute pancreatitis.