GLP-1 receptor agonist-induced diabetic ketoacidosis: A case report.

Zhang J, Ma Y, Zu Q, Wang X, Zhang Y

Medicine1 Sept 2024Cited by 11 (Europe PMC)

PMID39331877PMCIDPMC11441871DOI10.1097/md.0000000000039799PepBankPUB-39331877

Summary

RationaleGlucagon-like peptide-1 is an endogenous incretin that plays an active role in weight loss and hypoglycemia. Dulaglutide is a long-acting glucagon-like peptide-1 receptor agonist (GLP-1RA), which has been approved for the treatment of patients with type 2 diabetes (T2D). GLP-1RAs can increase insulin secretion and inhibit glucagon release, thereby leading to a decrease in blood glucose levels within the body. Specifically, GLP-1RAs control postprandial blood glucose levels by inhibiting hepatic glucose production and delaying gastric emptying. However, attention should be given to gastrointestinal adverse reactions. There are currently a few cases of GLP-1RA causing diabetic ketoacidosis (DKA).Patient concernsThe following report details the case of a 50-year-old Chinese female who has been living with diabetes for 12 years. Initially diagnosed with T2D, she was subsequently identified as a patient with latent autoimmune diabetes in adults (LADA) following treatment. The patient presented severe nausea, vomiting, and fatigue 1 day after injecting dulaglutide 1 time and discontinuing insulin therapy. She was diagnosed with severe DKA in the emergency department.DiagnosesLADA and DKA.InterventionsChanged from dulaglutide to insulin therapy.OutcomesAfter discontinuing dulaglutide and switching to insulin for blood glucose reduction, the patient's DKA was corrected, and blood glucose levels returned to normal.LessonsThis case suggests that clinicians should be alert to patients with severe DKA in cases of severe gastrointestinal adverse reactions after the use of GLP-1RAs. In addition, in most countries, GLP-1RAs are administered to patients with T2D, but we should consider the use of GLP-1RAs in patients with type 1 diabetes and LADA.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study6

4 results from studies that gave the peptide. 4 results from people.

01HumanCase report or seriesSafety outcome
A woman with LADA developed severe nausea after dulaglutide injection and insulin discontinuation.
In plain wordsA woman with autoimmune diabetes developed severe nausea after dulaglutide injection and insulin discontinuation.
Peptide
Dulaglutide (Trulicity)
Outcome
Not applicableSevere nausea
Study
n = 1
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
Dose not stated · injectionAs given in this study (human).
Source sentences
Summary
The patient presented severe nausea, vomiting, and fatigue 1 day after injecting dulaglutide 1 time and discontinuing insulin therapy.
2 context sentences(design, population, supporting numbers)
Summary · context
The following report details the case of a 50-year-old Chinese female who has been living with diabetes for 12 years.
Summary · context
Initially diagnosed with T2D, she was subsequently identified as a patient with latent autoimmune diabetes in adults (LADA) following treatment.
Show in the study text Report a problemFND-3933187701
02HumanCase report or seriesSafety outcome
A woman with LADA developed vomiting after dulaglutide injection and insulin discontinuation.
In plain wordsA woman with autoimmune diabetes developed vomiting after dulaglutide injection and insulin discontinuation.
Peptide
Dulaglutide (Trulicity)
Outcome
Not applicableVomiting
Study
n = 1
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
Dose not stated · injectionAs given in this study (human).
Source sentences
Summary
The patient presented severe nausea, vomiting, and fatigue 1 day after injecting dulaglutide 1 time and discontinuing insulin therapy.
2 context sentences(design, population, supporting numbers)
Summary · context
The following report details the case of a 50-year-old Chinese female who has been living with diabetes for 12 years.
Summary · context
Initially diagnosed with T2D, she was subsequently identified as a patient with latent autoimmune diabetes in adults (LADA) following treatment.
Show in the study text Report a problemFND-3933187702
03HumanCase report or seriesSafety outcome
A woman with LADA developed fatigue after dulaglutide injection and insulin discontinuation.
In plain wordsA woman with autoimmune diabetes developed fatigue after dulaglutide injection and insulin discontinuation.
Peptide
Dulaglutide (Trulicity)
Outcome
Not applicableFatigue
Study
n = 1
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated · injectionAs given in this study (human).
Source sentences
Summary
The patient presented severe nausea, vomiting, and fatigue 1 day after injecting dulaglutide 1 time and discontinuing insulin therapy.
2 context sentences(design, population, supporting numbers)
Summary · context
The following report details the case of a 50-year-old Chinese female who has been living with diabetes for 12 years.
Summary · context
Initially diagnosed with T2D, she was subsequently identified as a patient with latent autoimmune diabetes in adults (LADA) following treatment.
Show in the study text Report a problemFND-3933187703
04HumanCase report or seriesSafety outcome
A woman with LADA developed severe diabetic ketoacidosis after dulaglutide exposure and insulin discontinuation.
In plain wordsA woman with autoimmune diabetes developed severe ketoacidosis after dulaglutide exposure and insulin discontinuation.
Peptide
Dulaglutide (Trulicity)
Outcome
Not applicableSevere diabetic ketoacidosis
Study
n = 1
Outcome group
Adverse events · Metabolic and weight
Studied dose
Dose not stated · injectionAs given in this study (human).
Source sentences
Summary
She was diagnosed with severe DKA in the emergency department.
3 context sentences(design, population, supporting numbers)
Summary · context
The following report details the case of a 50-year-old Chinese female who has been living with diabetes for 12 years.
Summary · context
Initially diagnosed with T2D, she was subsequently identified as a patient with latent autoimmune diabetes in adults (LADA) following treatment.
Summary · context
The patient presented severe nausea, vomiting, and fatigue 1 day after injecting dulaglutide 1 time and discontinuing insulin therapy.
Show in the study text Report a problemFND-3933187704

Studies that did not test the peptide alone2

In this study, Dulaglutide (Trulicity) was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Dulaglutide (Trulicity).

05HumanNot a test of Dulaglutide (Trulicity) aloneCase report or seriesOther
In a woman with LADA, ketoacidosis resolved after dulaglutide discontinuation and a switch to insulin.
In plain wordsIn a woman with autoimmune diabetes, ketoacidosis resolved after dulaglutide discontinuation and a switch to insulin.
Peptide
Dulaglutide (Trulicity)
Outcome
DecreaseKetoacidosis resolution after treatment change
Study
n = 1
Outcome group
Glycemic control · Metabolic and weight
Source sentences
Summary
After discontinuing dulaglutide and switching to insulin for blood glucose reduction, the patient's DKA was corrected, and blood glucose levels returned to normal.
3 context sentences(design, population, supporting numbers)
Summary · context
The following report details the case of a 50-year-old Chinese female who has been living with diabetes for 12 years.
Summary · context
Initially diagnosed with T2D, she was subsequently identified as a patient with latent autoimmune diabetes in adults (LADA) following treatment.
Summary · context
The patient presented severe nausea, vomiting, and fatigue 1 day after injecting dulaglutide 1 time and discontinuing insulin therapy.
In this study, Dulaglutide (Trulicity) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Dulaglutide (Trulicity).
Show in the study text Report a problemFND-3933187705
06HumanNot a test of Dulaglutide (Trulicity) aloneCase report or seriesOther
In a woman with LADA, blood glucose normalized after dulaglutide discontinuation and a switch to insulin.
In plain wordsIn a woman with autoimmune diabetes, blood sugar returned to normal after dulaglutide discontinuation and a switch to insulin.
Peptide
Dulaglutide (Trulicity)
Outcome
DecreaseBlood glucose after treatment change
Study
n = 1
Outcome group
Glycemic control · Metabolic and weight
Source sentences
Summary
After discontinuing dulaglutide and switching to insulin for blood glucose reduction, the patient's DKA was corrected, and blood glucose levels returned to normal.
3 context sentences(design, population, supporting numbers)
Summary · context
The following report details the case of a 50-year-old Chinese female who has been living with diabetes for 12 years.
Summary · context
Initially diagnosed with T2D, she was subsequently identified as a patient with latent autoimmune diabetes in adults (LADA) following treatment.
Summary · context
The patient presented severe nausea, vomiting, and fatigue 1 day after injecting dulaglutide 1 time and discontinuing insulin therapy.
In this study, Dulaglutide (Trulicity) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Dulaglutide (Trulicity).
Show in the study text Report a problemFND-3933187706

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
22 Oct 2026, 02:25 UTC
Study results updated
Version 1
21 Oct 2026, 18:59 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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