Tirzepatide in recurrent hypertriglyceridemia-mediated pancreatitis and type 2 diabetes: a case report

In a woman born in 1993 with recurrent hypertriglyceridemia-mediated pancreatitis and type 2 diabetes, starting tirzepatide after stabilization of an acute episode was followed by normalization of triglycerides, improved HbA1c, discontinuation of insulin, and no further pancreatitis over 12 months of follow-up. The case shows only an association, not causality.

Journal article — single-patient case report. Population: Woman born in 1993 with recurrent hypertriglyceridemia-mediated acute pancreatitis, type 2 diabetes, chronic fibrosing pancreatitis, and severe MASLD. Sample size: 1. Follow-up: 12 months. Interventions: Tirzepatide.

At tirzepatide initiation, triglycerides were 335 mg/dL and HbA1c was 7.0%. During follow-up, insulin was fully discontinued, triglycerides normalized to 137 mg/dL at 3 months and 85 mg/dL at 12 months, HbA1c improved to 5.5%, and inflammatory markers normalized. No further pancreatitis episodes occurred during the reported follow-up.

Researchers studying tirzepatide would care because this is a documented case of its use in a patient with recurrent hypertriglyceridemia-mediated pancreatitis and type 2 diabetes, a setting in which incretin-based therapy is often withheld. The metabolic improvements and absence of recurrent pancreatitis over 12 months are hypothesis-generating. The case does not establish that tirzepatide prevents pancreatitis or is safe in this population; the authors explicitly note the association only.

Key findings

Triglycerides fell from 335 mg/dL at tirzepatide initiation to 137 mg/dL at 3 months and 85 mg/dL at 12 months.
HbA1c improved from 7.0% to 5.5% during follow-up.
Insulin was fully discontinued during follow-up.
No further pancreatitis episodes occurred during the reported 12-month follow-up.
Inflammatory markers normalized during follow-up.
At the acute presentation, triglycerides were 4.400 mg/dL despite prior lifestyle measures, fenofibrate, omega-3 fatty acids, and intensified insulin therapy.

Limitations

The authors state this is a single-patient observation and that the favorable course represents association only, not causality.
There was no control arm, so the tirzepatide-specific effect cannot be separated from recovery after fasting, intensified insulin therapy, or other background treatments.
A single case limits generalizability to other patients with hypertriglyceridemia-mediated pancreatitis.

The record

Journal: Cardiovascular diabetology. Endocrinology reports 12(1): 50
Published: 2026-08-01
PMID: 42538551 — DOI: 10.1186/s40842-026-00318-z
Author countries: Germany

Peptide profiles: Tirzepatide.

All indexed evidence: Tirzepatide trials & papers.