Journal of diabetes science and technology

Deciding Whether to Pause Glucagon-Like Peptide-1 Medicines Before Surgery or Procedures with Limited Evidence

Updated

Abstract

Discontinuing glucagon-like peptide-1 receptor agonist (GLP-1 RA) treatment before surgery may worsen glycemic control in patients with diabetes.

  • Current recommendations to stop GLP-1 RA agents before surgery are based on concerns about pulmonary aspiration but lack sufficient scientific evidence.
  • There is a need for observational and prospective studies to assess the risk of pulmonary aspiration in patients using GLP-1 RA.
  • Understanding the short-term effects of discontinuing GLP-1 RA on glycemic control is crucial for managing patients with diabetes during elective surgeries.
  • An alternative multidisciplinary approach is suggested for managing patients undergoing elective surgery while waiting for more safety data.

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Funding

Competing interests

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: GU is partly supported by research grants from National Institutes of Health (NIH/NATS UL 3UL1TR002378-05S2) from the Clinical and Translational Science Award program, and from National Institutes of Health and National Center for Research Resources (NIH/NIDDK 2P30DK111024-06). GU has received research support (to Emory University) from Bayer, Abbott, and Dexcom, and has served in Advisory Boards for Dexcom and Glycare. FJP reports research support (to Emory University) from Insulet, Dexcom, Novo Nordisk, Tandem, and Ideal Medical Technologies and receives consulting fees from Dexcom and Medscape. RJG has received research support (to Emory University) for investigator-initiated studies from Novo Nordisk, Dexcom, and Eli Lilly and consulting/advisory/honoraria fees from Abbott, Dexcom, Eli Lilly, Novo Nordisk, Bayer, and Boehringer. ED reports no conflicts of interest.
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