From Glycaemic Control to Gastrointestinal Crisis: A Case of Semaglutide-Induced Pancreatitis

Acute pancreatitis is a common illness usually secondary to gallstones, alcohol consumption, and hypertriglyceridemia. Less common causes include drug-induced pancreatitis. Semaglutide, a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist, is a novel agent for the treatment of type 2 diabetes mellitus (T2DM), obesity, and cardiovascular disease (CVD) risk reduction in diabetics, with documented gastrointestinal side effects but an extremely rare association with pancreatitis. We report a case of a 68-year-old female with a history of T2DM, obesity, and hypertension who experienced acute pancreatitis following the start of semaglutide 0.5 mg once weekly for one month. The patient also had a possible history of pancreatitis after taking exenatide and liraglutide. The patient presented with intense epigastric pain, nausea, and bloating, with increased lipase levels. Imaging evaluation did not reveal evidence of gallstones or pancreatic inflammation. Since there was a temporal correlation between starting semaglutide and the development of symptoms, the drug was withheld, and the patient responded to supportive measures with intravenous hydration and management of pain. This case highlights possible association of semaglutide with pancreatitis. Prompt recognition of possible association and drug cessation are essential for the best possible outcomes. More research is required to understand the association between semaglutide and pancreatitis and an underlying pathophysiology to develop improved guidelines for safe use.