Gastrointestinal effects of GLP-1 receptor agonists: mechanisms, management, and future directions

Aug 3, 2024The lancet. Gastroenterology & hepatology

How GLP-1 receptor drugs affect digestion: causes, treatment, and future possibilities

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may significantly slow gastric emptying.

Marked slowing of gastric emptying is associated with reduced post-prandial blood glucose responses in type 2 diabetes.
Increased gastric retention of food could elevate the risk of aspiration during surgeries or upper gastrointestinal procedures.
Current pre-procedural guidelines are limited due to inadequate evidence regarding the effects of long-acting GLP-1RAs on gastric emptying.
Proposed management pathways for patients on GLP-1RA therapy aim to address these challenges.
Future research priorities include better understanding the gastrointestinal effects of GLP-1RAs.

AI simplified

The availability of glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) such as liraglutide and semaglutide, and a GLP-1 and glucose dependent insulinotropic polypeptide coagonist (tirzepatide) represents a paradigm shift in the management of both type 2 diabetes and obesity. There is now considerable attention, including in the public media, on the effect of both long-acting and short-acting GLP-1RAs to delay gastric emptying. Although slowed gastric emptying is integral to reducing post-prandial blood glucose responses in type 2 diabetes, marked slowing of gastric emptying might also increase the propensity for longer intragastric retention of food, with a consequent increased risk of aspiration at the time of surgery or upper gastrointestinal endoscopy. This Personal View summarises current knowledge of the effects of GLP-1 and GLP-1RAs on gastrointestinal physiology, particularly gastric emptying, and discusses the implications for the development of sound pre-operative or pre-procedural guidelines. The development of pre-procedural guidelines is currently compromised by the poor evidence base, particularly in relation to the effect of long-acting GLP-1RAs on gastric emptying. We suggest pre-procedural management pathways for individuals on GLP-1RA-based therapy and discuss priorities for future research.

Full Text

Full text is available at the source.

View full text (XML) ↗View full text ↗

Gastrointestinal effects of GLP-1 receptor agonists: mechanisms, management, and future directions

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief