The nurse is caring for a client with type 2 diabetes mellitus who is taking liraglutide. Which problem(s) in the client's history may increase the risk for development of pancreatitis? Select all that apply.

Rationale: A. High triglyceride levels: Elevated triglycerides are a major risk factor for pancreatitis because they can cause pancreatic inflammation by leading to the accumulation of free fatty acids that injure pancreatic tissue. Clients with uncontrolled lipid levels require close monitoring while on medications like liraglutide. B. Chronic alcohol use: Long-term alcohol consumption damages the pancreas directly by promoting inflammation and fibrosis, significantly increasing the risk of pancreatitis. Chronic use compounds the pancreatitis risk when the client is also taking medications like liraglutide that carry a pancreatic warning. C. Gallstones: Gallstones can obstruct the pancreatic duct, leading to the backflow of digestive enzymes and resulting in pancreatic inflammation. A history of gallstones makes the client particularly vulnerable to developing pancreatitis while on incretin-based therapies like liraglutide. D. Moderate daily alcohol use: Moderate alcohol intake is less strongly associated with pancreatitis compared to heavy or chronic use. Although any alcohol use can pose some risk, moderate consumption alone is generally not considered a primary risk factor for drug-induced pancreatitis. E. Pancreatitis: A personal history of pancreatitis indicates previous pancreatic injury, making the pancreas more susceptible to future episodes. Starting liraglutide in someone with a history of pancreatitis requires extreme caution due to the increased likelihood of recurrence.