Glucagon-like peptide-1 therapy and the exocrine pancreas: innocent bystander or friendly fire?

In the present edition of Diabetologia , Nachnani and colleagues report that rats treated with the glucagon-like-peptide-1 (GLP-1) mimetic, exendin-4, for 75 days developed low-grade pancreatitis [ 1 ]. The obvious question is whether low-grade pancreatitis is also present in humans treated with synthetic exendin-4 (exenatide) or other GLP-1-based therapies? The paper by Nachnani et al. is a timely addition to an area of growing interest and controversy in which, at present, there are more questions than answers.