Glycaemic changes during early semaglutide treatment: a case of pancreatic adenocarcinoma

May 22, 2026Acta diabetologica

Blood sugar changes during early treatment with semaglutide in pancreatic cancer

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Abstract

A 55-year-old woman experienced increased fasting plasma glucose from 107 mg/dL to 169 mg/dL after one month of semaglutide treatment despite a 4 kg weight loss.

  • Initial glycated hemoglobin was 6.0%, which increased to 6.6% after treatment.
  • Latent autoimmune diabetes in adults was ruled out by negative autoantibodies and preserved C-peptide levels.
  • Carbohydrate antigen 19-9 levels were markedly elevated.
  • Magnetic resonance imaging of the pancreas revealed a 4 × 3 cm irregular mass.
  • Surgical exploration confirmed liver metastases and a diagnosis of metastatic pancreatobiliary adenocarcinoma.
  • Atypical glycaemic changes during early treatment with semaglutide should be interpreted cautiously.

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