BMJ case reportsSep 24, 2025

Autoimmune Pancreatitis Linked to GLP-1 Agonist Treatment

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jun 27, 2026

Abstract

Essence

Three cases raise a hypothesis that GLP-1 agonists could trigger or worsen type 1 autoimmune pancreatitis in susceptible patients.

Evidence

Case series reports three type 1 autoimmune pancreatitis cases following GLP-1 agonist treatment for type 2 diabetes and discusses possible pancreatic hypertrophy and antigen-presentation mechanisms.

Caveat

Causation remains unproven because the report has only three cases, no comparator group, and a mechanistic hypothesis rather than direct proof.

Simplified

Two main types of autoimmune pancreatitis (AIP) have been described: type 1, linked to IgG4-related disease, and type 2, associated with inflammatory bowel diseases. Recently, a third type has been associated with immune checkpoint inhibitors. In our series, we report three cases of type 1 AIP following glucagon-like peptide (GLP)-1 agonist treatment for type 2 diabetes mellitus (DM). GLP-1 agonists may be implicated in pancreatitis development mainly due to their effect on biliary motility and pancreatic cell proliferation. While causation remains unproven, it could be possible that GLP-1 induced pancreatic hypertrophy might influence cell metabolism and antigen presentation in predisposed individuals, altering the immunological milieu and eventually leading to type 1 AIP. Similarly, we hypothesise that GLP-1 agonists use in type 1 AIP patients may lead to pancreatitis recurrence. Accordingly, insulin-based therapeutic regimens may be preferred in type 2 DM patients also affected by type 1 AIP.