Acalculous pyelonephritis and cholecystitis occurring simultaneously in a diabetic patient on sitagliptin therapy

Dipeptidyl peptidase‑4 (DPP‑4) inhibitors are a new class of anti‑diabetic drugs. They control both fasting and postprandial hyperglycemia by inhibiting degradation of incretin hormones, such as, glucagon‑like peptide‑1(GLP‑1) and glucose‑dependent insulinotropic polypeptide (GIP). Sitagliptin is the first DPP‑4 inhibitor to be marketed in India. In addition to its glucose lowering effect, it also suppresses immunity resulting in various infections in a diabetes patient. Here, we describe the simultaneous development of two infections (acalculous pyelonephritis and cholecystitis) in a postmenopausal female patient, well‑controlled on sitagliptin‑based anti‑diabetic therapy.