Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which of the following diabetes medications carries a risk for pancreatitis?

1. Exenatide

2. Metformin

3. Sitagliptin

4. Acarbose

The correct answer is: Exenatide

Exenatide is a medication in the glucagon-like peptide-1 (GLP-1) receptor agonist class, which has been associated with an increased risk of pancreatitis. Several studies and clinical reports have highlighted cases where patients taking exenatide developed pancreatitis, prompting warnings and recommendations for careful monitoring of patients receiving this treatment. The mechanism of this potential adverse effect is not entirely clear but may involve the stimulation of pancreatic secretions or alterations in pancreatic physiology. While other medications, such as sitagliptin (a DPP-4 inhibitor), have also been scrutinized for pancreatic risks, the evidence linking exenatide to pancreatitis is more substantial and has led to clearer warnings. Metformin and acarbose do not carry a notable risk for pancreatitis; metformin is primarily associated with gastrointestinal side effects and rare cases of lactic acidosis, while acarbose, an alpha-glucosidase inhibitor, is generally well-tolerated with a low risk for such complications. This specific association for exenatide emphasizes the need for healthcare providers to be aware of potential side effects and monitor patients accordingly while using this medication.