Acute pancreatitis and type 2 diabetes mellitus: who is guilty?
Year 2015,
Volume: 1 Issue: 2, 74 - 77, 04.07.2015
Ferit Kucukler
,
Yasin Simsek
Murat Baglicaklioglu
Gupse Adali
Serdar Guler
Abstract
Many factors play a role in the etiology of acute pancreatitis and its pathogenesis is not fully understood. Dipeptidyl peptidase 4 (DPP-4) inhibitors are a new group of agents for the treatment of Diabetes Mellitus (DM). There are some controversies about specific adverse events such as pancreatitis and hypersensitivity reactions. A 50-year-old morbid obese woman presented with upper abdomen pain after the eating food, nausea and vomiting. She was diagnosed with type 2 diabetes mellitus 7 years ago. Vildagliptin had been added to her treatment six months ago. Abdominal examination revealed epigastric tenderness with guarding. Laboratory data revealed elevated pancreatic enzymes. Abdominal computed tomography (CT) showed features of pancreatitis. Vildagliptin was stopped and patient's symptoms had diminished in parallel with normalization of pancreatic enzymes; and at the 5th day patient was discharged with healthy condition. She was free of symptoms and all laboratory data were normal at the 30th day after discharge. It is important to keep in mind that diabetic patients have an increased risk of pancreatitis which may be related to obesity, hyperlipidemia and/or drugs.
References
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Year 2015,
Volume: 1 Issue: 2, 74 - 77, 04.07.2015
Ferit Kucukler
,
Yasin Simsek
Murat Baglicaklioglu
Gupse Adali
Serdar Guler
References
- Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013:108:1400-15.
- Girman CJ, Kou TD, Cai B, Alexander CM, O'Neill EA, WilliamsHerman DE, Katz L. Patients with type 2 diabetes mellitus have higher risk for acute pancreatitis compared with those without diabetes. Diabetes Obes Metab. 2010;12:766-71.
- Noel RA, Braun DK, Patterson RE, Bloomgren GL. Increased risk of acute pancreatitis and biliary disease observed in patients with type 2 diabetes: a retrospective cohort study. Diabetes Care 2009;32: 834-8.
- Gumbs AA. Obesity, pancreatitis, and pancreatic cancer. Obes Surg. 2008;18:1183-7.
- Goossen K, Graber S. Longer term safety of dipeptidyl peptidase- 4 inhibitors in patients with type 2 diabetes mellitus: systematic review and meta-analysis. Diabetes Obes Metab. 2012;14:1061-72.
- Ligueros-Saylan M, Foley J, Schweizer A, Couturier A, Kothny W. An assessment of adverse effects of vildagliptin versus comparators on the liver, the pancreas, the immune system, the skin and in patients with impaired renal function from a large pooled database of Phase II and III clinical trials. Diabetes Obes Metab. 2010;12:495-509.
- Girgis CM, Champion BL. Vildagliptin-induced acute pancreatitis. Endocr Pract. 2011;17:48-50.
- US Food and Drug Administration. MedWatch 2009 Safety Alerts for Human Medical Products: Sitagliptin (marketed as Januvia and Janumet) - acute pancreatitis. September 25, 2009. Available at: http:// www.fda.gov/ Safety/ MedWatch/ SafetyInformation/ SafetyAlertsforHumanMedicalProducts/ ucm183800.htm. Accessed for verification June 13, 2011.
- Elashoff M, Matveyenko AV, Gier B, Elashoff R, Butler PC. Pancreatitis, pancreatic, and thyroid cancer with glucagon-like peptide-1-based therapies. Gastroenterology. 2011;141:150-6.
- Saraogi R, Mallik R, Ghosh S. Mild acute pancreatitis with vildagliptin use. Indian J Endocr Metab. 2012;16:S480-2.
- Kunjathaya P, Ramaswami PK, Krishnamurthy AN, Bhat N. Acute necrotizing pancreatitis associated with vildagliptin. JOP. 2013;14:81-4.
- Butler AE, Galasso R, Matveyenko A Rizza RA, Dry S, Butler PC. Pancreatic duct replication is increased with obesity and type 2 diabetes in humans. Diabetologia. 2010;53:21-6.
- Matveyenko AV, Dry S, Cox HI, Moshtaghian A, Gurlo T, Galasso R, et al. Beneficial endocrine but adverse exocrine effects of sitagliptin in the human islet amyloid polypeptide transgenic rat model of type 2 diabetes: interactions with metformin. Diabetes. 2009;58:1604-15.
- Martinez J, Sanchez-Paya J, Palazon JM, Suazo-Barahona J, Robles-Diaz J, Perez-Mateo M. Is obesity a risk factor in acute pancreatitis? A meta-analysis. Pancreatology. 2004;4:42-8.
- Premkumar R, Phillips AR, Petrov MS, Windsor JA. The clinical relevance of obesity in acute pancreatitis: Targeted systematic reviews. Pancreatology. 2015;15:25-33.