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Last month while I was attending on the inpatient teaching service, my team admitted a middle-aged diabetic man who had acute pancreatitis, with serum lipase level 10 times above the upper limit of normal. He drank no alcohol, imaging revealed no gallstones, and his triglyceride level was normal. He reported only one recent change in medications: The dipeptidyl peptidase (DPP)-4 inhibitor sitagliptin (Januvia) had been initiated several months previously. A suspected association between this drug class and acute pancreatitis has been controversial.
In the February 2017 issue of Diabetes Care, two teams conducted meta-analyses of three large randomized placebo-controlled trials involving the DPP-4 inhibitors sitagliptin, saxagliptin (Onglyza)…