Khan Abu Baker, Shah Aimal, Ahmad Saad, Khan Moiz I, Amir Ahsan
Internal Medicine, Ayub Teaching Hospital, Abbottabad, PAK.
Medicine, Nazareth Hospital - Trinity Health Mid-Atlantic, Philadelphia, USA.
Cureus. 2023 May 6;15(5):e38630. doi: 10.7759/cureus.38630. eCollection 2023 May.
The article discusses the use of dulaglutide (Trulicity) in treating type 2 diabetes mellitus. Dulaglutide is a synthetic analog of glucagon-like peptide (GLP-1) that binds to GLP-1 receptors, enhancing insulin secretion and reducing postprandial glucagon and food intake. Dulaglutide has a longer half-life than GLP-1, making it more clinically useful. The recommended dosage of dulaglutide is 0.75 mg/0.5 mL subcutaneously once weekly, which can be increased as needed for adequate glycemic control. We describe a case of acute pancreatitis in a 37-year-old male with a past medical history of type 2 diabetes mellitus who was admitted for epigastric pain radiating to the back. Lipase level was elevated at 1508, and a computed tomography (CT) scan of the abdomen showed fat stranding around the pancreas consistent with pancreatitis. The patient was on dulaglutide (Trulicity) at 0.75 mg q. weekly for about two years; this dose was increased to 1.5 mg q. weekly two months ago. He developed symptoms of abdominal pain, nausea, and vomiting after receiving the last dose of Trulicity, which was two weeks before he presented to the emergency department as a cause of acute pancreatitis. Dulaglutide use has been known to cause a mild elevation of pancreatic enzyme levels; there have been few reported cases of dulaglutide-associated acute pancreatitis in the literature. The case report highlights the adverse effects of dulaglutide in diabetic patients and the importance of monitoring pancreatic enzyme levels in patients taking dulaglutide.
本文讨论了度拉糖肽（度易达）在治疗2型糖尿病中的应用。度拉糖肽是一种胰高血糖素样肽-1（GLP-1）的合成类似物，它与GLP-1受体结合，增强胰岛素分泌，减少餐后胰高血糖素分泌和食物摄入量。度拉糖肽的半衰期比GLP-1长，使其在临床上更有用。度拉糖肽的推荐剂量为0.75毫克/0.5毫升，皮下注射，每周一次，可根据血糖控制情况按需增加剂量。我们描述了一例37岁男性急性胰腺炎病例，该患者有2型糖尿病病史，因上腹部疼痛放射至背部入院。脂肪酶水平升高至1508，腹部计算机断层扫描（CT）显示胰腺周围脂肪沉积，符合胰腺炎表现。该患者使用度拉糖肽（度易达）0.75毫克，每周一次，约两年；两个月前剂量增加至1.5毫克，每周一次。在接受最后一剂度易达后，他出现腹痛、恶心和呕吐症状，这是在他因急性胰腺炎就诊于急诊科前两周。已知使用度拉糖肽会导致胰腺酶水平轻度升高；文献中报道的度拉糖肽相关急性胰腺炎病例很少。该病例报告强调了度拉糖肽在糖尿病患者中的不良反应以及监测使用度拉糖肽患者胰腺酶水平的重要性。
