The American Association of Endocrinologists (AACE) and the American Diabetes Association believe that the study by Singh et al, Glucagon-like Peptide 1-Based Therapies and Risk of Hospitalization for Acute Pancreatitis in Type 2 Diabetes Mellitus, published online February 25th in JAMA Internal Medicine does not provide the basis for changing treatment in people with diabetes. Fortunately, there will be new data available relatively soon which will allow physicians to definitively assess risks and benefits of this class of medicines.
The analysis is a retrospective study using data from an administrative database. This type of analysis is not considered as robust as a prospective randomized controlled clinical trial, the gold standard for evaluating treatments. There are currently nine ongoing, prospective, controlled trials of GLP-1 based therapy with over 65,000 subjects, which should provide answers to these important safety questions.
While there are risks and benefits associated with any therapy, the retrospective analysis indicates GLP-1 based therapies are associated with a relatively small excess risk of hospitalization for acute pancreatitis, with only two additional cases per 100 patients over a three-year period. This same population of adults, between the ages of 18-64 with type 2 diabetes, had a greater risk of hospitalization for acute pancreatitis if they used tobacco, consumed alcohol or were obese.
As with any therapy, we encourage patients to speak with their doctors to assess which treatments are best for them and to not stop therapy on their own without consulting their doctors.