Vomiting as Common Adverse Event of Exenatide: A Case of Diabetic Patient with Type 2 and Duodenal Bulb and Gastric Ulcers who Showed Severe Vomiting Increased Gradually after Exenatide Injections

Abstract

Background: Although exenatide is a valuable option of treatments for type 2 diabetes (T2DM) in obese patients, mild to moderate nausea or vomiting in a usual dose of administration is most common. The adverse event usually decreases with time. Methods and Results: A case of 58-year-old female with T2DM and gastric ulcers is reported. Before treatment with exenatide, she had hemoglobin A1c (NGSP) 7.8% and had received oral miglitol, metformin and DPP-4 inhibitor for T2DM, oral α-blocker and telmisartan for hypertension and oral pitavastatin for dyslipidemia. Before the treatment, she had high body mass index of 44.2 kg/m 2 , but no evidence of micro-and macrovascular disturbances and no symptoms of duodenal bulb and gastric ulcers. After twice daily subcutaneous injections of 10 µg/day exenatide, vomiting developed gradually. We tried to examine exact causes using endoscopy. She was diagnosed with duodenal bulb and gastric ulcers with Helicobacter pylori. She received bactericides drugs. After then, the bacteria were eradicated and vomiting gradually disappeared and she was re-treated with the same dosing schedule of exenatide and had a good control.