Comparative analysis found GLP-1 RAs had lower risk of adverse pancreatic events compared to SGLT2 inhibitors and DPP-4 inhibitors, challenging the longstanding pancreatitis concern.
Actually safer for pancreasGLP-1 drugs had LOWER pancreatic adverse events than comparison drugs — turning the longstanding pancreatitis concern on its head
What the researchers found
GLP-1 RAs had lower risk of adverse pancreatic events than SGLT2i and DPP-4i in comparative analysis, challenging the longstanding GLP-1 pancreatitis concern.
Why it matters
The pancreatitis concern has limited GLP-1 prescribing. Finding that GLP-1 drugs are actually SAFER for the pancreas than comparators could change prescribing behavior.
How the study worked
Comparative risk analysis of adverse pancreatic events across GLP-1 RA, SGLT2i, and DPP-4i drug classes.
What this study cannot tell us
Observational comparison. Cannot definitively exonerate GLP-1 drugs. Pancreatic events in diabetes are multifactorial.
How to read the evidence
Comparative pharmacovigilance analysis. Important for revising safety narrative.
When this study was published
Published in 2025.
The bigger picture
The GLP-1 pancreatitis narrative may need revision — comparative data suggests these drugs are no more pancreas-risky than alternatives.
Questions still open
- Should the pancreatitis warning for GLP-1 drugs be reconsidered?
- Why do DPP-4 inhibitors show higher pancreatic risk?
- Should pancreatitis history still be a contraindication for GLP-1 drugs?
Common questions
Do GLP-1 drugs cause pancreatitis?
Should I worry about my pancreas on GLP-1 drugs?
Read the original research
Comparative Risk of Adverse Pancreatic Events With GLP-1 Receptor Agonists, SGLT2 Inhibitors, DPP4 Inhibitors, and Sulfonylureas Among Adults With Type 2 Diabetes at Moderate Cardiovascular Disease Risk.
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 32(1), 23-30
Citation
Kalathiya, Urja N; Herrin, Jeph; Swarna, Kavya Sindu; Deng, Yihong; Polley, Eric C; Neumiller, Joshua J; Galindo, Rodolfo J; Umpierrez, Guillermo E; Ross, Joseph S; Mickelson, Mindy M; McCoy, Rozalina G. (2026). Comparative Risk of Adverse Pancreatic Events With GLP-1 Receptor Agonists, SGLT2 Inhibitors, DPP4 Inhibitors, and Sulfonylureas Among Adults With Type 2 Diabetes at Moderate Cardiovascular Disease Risk.. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 32(1), 23-30. https://doi.org/10.1016/j.eprac.2025.09.004