Liraglutide-induced Acute Gastroparesis

Abstract

We describe a case of liraglutide-induced acute gastroparesis in a 52-year-old man with a history of well-controlled type 2 diabetes who presented with symptoms of gastric outlet obstruction. The patient responded markedly to conservative treatment with gastric suctioning, antiemetic and prokinetic therapy, and discontinuation of liraglutide with a resolution of his symptoms. This case highlights the importance of considering drug-induced gastroparesis as an etiology of unexplained upper abdominal pain, nausea, and early satiety, especially in the absence of mechanical obstruction.

Suspected Gastroparesis With Concurrent Gastroesophageal Reflux Disease Induced by Low-Dose Liraglutide

“…The diagnosis of GP requires the demonstration of delayed gastric emptying through several methods including scintigraphy, which is the gold standard test, wireless motility camera, or carbon breath testing. In addition, mechanical obstruction must be excluded [ 1 , 4 ]. In this case, we could not perform examination for delayed gastric emptying because of limited resources in our semi-rural community hospital.…”

“…Causes of GP include diabetes mellitus (DM), thyroid dysfunction, neurological disease, prior gastric or bariatric surgery, autoimmune disorders, and drugs such as glucagon-like peptide type 1 (GLP-1) analogs [ 1 , 2 ]. Liraglutide, one of the GLP-1 analogs used for the treatment of DM, is a drug that stimulates insulin secretion from pancreatic beta-cells, inhibits glucagon secretion from pancreatic alpha cells, and suppresses gastric peristalsis [ 3 , 4 ]. Liraglutide not only lowers blood glucose in DM patients but also enhances pancreatic beta cell function, decreases body weight, and exhibits antihypertensive effects when administered once daily.…”

“…It is also reported to cause decreased esophageal peristalsis [ 5 ]. However, there have been only a few case reports citing GP induced by liraglutide [ 2 , 4 ]. Here, we report a case of suspected GP in a patient with type 2 DM (T2DM) newly treated with liraglutide.…”

Gastroparesis With the Initiation of Liraglutide: A Case Report

“…Though gastroparesis is a documented adverse event of liraglutide, not much research has been conducted to verify its effect on patients. Rai and colleagues reported a case of liraglutide-induced acute gastroparesis in a 52-year-old gentleman with a history of well-controlled diabetes mellitus [ 13 ]. One study documented that three mg of liraglutide delayed gastric emptying at five and 16 weeks [ 10 ].…”

Response to Dahl et al.: Oral semaglutide improves postprandial glucose and lipid metabolism, and delays gastric emptying, in subjects with type 2 diabetes

“…gastroparesis) is uncertain; 'delayed gastric emptying' is now a labelled adverse effect of the GLP-1RA, liraglutide. 11,12 The effect of both 'short-' and 'long-acting' GLP-1RAs to slow gastric emptying is more marked when the baseline rate of gastric emptying is comparatively faster. [13][14][15] Accordingly, patients with longstanding, poorly controlled type 2 diabetes associated with autonomic neuropathy and gastroparesis may be at a comparatively lower risk of further slowing.…”