Should We Stop Glucagon-Like Peptide-1 Receptor Agonists Before Surgical or Endoscopic Procedures? Balancing Limited Evidence With Clinical Judgment.
Guillermo E UmpierrezFrancisco J PasquelElizabeth DugganRodolfo J GalindoPublished in: Journal of diabetes science and technology (2024)
The American Society of Anesthesiologists (ASA) Task Force recently recommended discontinuing glucagon-like peptide-1 receptor agonist (GLP-1 RA) agents before surgery because of the potential risk of pulmonary aspiration. However, there is limited scientific evidence to support this recommendation, and holding GLP-1 RA treatment may worsen glycemic control in patients with diabetes. As we await further safety data to manage GLP-1 RA in the perioperative period, we suggest an alternative multidisciplinary approach to manage patients undergoing elective surgery. Well-conducted observational and prospective studies are needed to determine the risk of pulmonary aspiration in persons receiving GLP-1 RA for the treatment of diabetes and obesity, as well as the short-term impact of discontinuing GLP-1 RA on glycemic control before elective procedures in persons with diabetes.
Keyphrases
- glycemic control
- type diabetes
- patients undergoing
- rheumatoid arthritis
- blood glucose
- weight loss
- insulin resistance
- disease activity
- minimally invasive
- ultrasound guided
- pulmonary hypertension
- ankylosing spondylitis
- coronary artery bypass
- cardiovascular disease
- interstitial lung disease
- metabolic syndrome
- systemic lupus erythematosus
- body mass index
- coronary artery disease
- deep learning
- systemic sclerosis
- electronic health record
- acute kidney injury
- artificial intelligence
- combination therapy
- data analysis