Emma Barry¹, Vivian Zhang^1,, Lyn Dea^{1, 2}

Options for treating type 2 diabetes mellitus have evolved in the last few decades with the introduction of glucagon-like-peptide 1 (GLP-1) agonists and dipeptidyl peptidase (DPP-4) inhibitors. These medications are known to slow gastric emptying and have proven to be an effective alternative to insulin in the treatment of diabetes. Newer drugs such as SGLT-2 inhibitors and cardioprotective drugs contribute additional benefit in the management of diabetes. While there have been reports of the side effects associated with individual medications, there is less research on the combined effects of a complete medication regimen. This case describes a patient who developed acute pancreatitis and subsequent diabetic ketoacidosis following major changes to her diabetes medications, including the addition of a DPP-4 inhibitor and dosage increase of a GLP-1 agonist to her existing regimen of an SGLT-2 inhibitor. Therefore, we propose the need for further research into the consequences of prescribing a combination of medications for the treatment of type 2 diabetes.

case report, diabetes, multi-drug, adverse effects, pancreatitis, diabetic ketoacidosis