GLP-1 receptor agonists and acute pancreatitis: fact or overstated risk?

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for type 2 diabetes mellitus (T2DM) and weight management. These medications mimic the effects of the intestinal hormone GLP-1, thereby enhancing insulin secretion, reducing glucagon release, inducing satiety, and slowing gastric emptying. Their therapeutic scope now extends to cardiometabolic conditions and metabolic-associated steatotic liver disease (MASLD). Despite their clinical utility, GLP-1 RAs are frequently associated with gastrointestinal adverse effects-including nausea, vomiting, and diarrhoea-reported in up to 80% of patients, often in a dose-dependent manner. Concerns have also emerged regarding a potential association with acute pancreatitis.