Acute Pancreatitis Associated With Semaglutide in a Patient With Multimorbidity: A Case Report

Semaglutide, a long-acting glucagon-like peptide-1 receptor agonist (GLP-1 RA), has shown robust efficacy in glycemic control, weight reduction, and cardiovascular protection, but concerns remain regarding rare adverse events such as acute pancreatitis. We report a 59-year-old man with type 2 diabetes, stage IIIA colon cancer post-hemicolectomy and chemotherapy, stage 4 chronic kidney disease, hypertension, and dyslipidemia who developed acute pancreatitis after 2.5 years of weekly semaglutide therapy. He presented with epigastric pain and elevated lipase, while abdominal ultrasound revealed only mild pancreatic parenchymal heterogeneity without peripancreatic fluid collection. The patient improved with conservative management, and semaglutide was discontinued in favor of linagliptin, with no recurrence of symptoms during three months of follow-up. This case highlights the potential risk of pancreatitis in patients with multimorbidity, a population frequently excluded from randomized controlled trials and underrepresented in real-world prescribing due to socioeconomic barriers. Clinicians should remain vigilant when prescribing semaglutide to patients with multiple underlying chronic conditions, and further studies focusing on multimorbid populations are warranted to clarify its safety profile.