Managing Diabetes Medicines Around Surgery: Glucagon-like Peptide-1 and Sodium-Glucose Transporter 2 Drugs

Patients taking GLP-1 receptor agonists with the highest risk of aspiration are non-fasters who have recently started the drug or increased their dose.

• Asymptomatic patients on stable doses of GLP-1 receptor agonists may continue their medication during the peri-operative period.
• SGLT 2 inhibitor use is linked to a risk of euglycemic diabetic ketoacidosis, especially in insulin-treated patients who fast for extended periods.
• Patients on SGLT 2 inhibitors should discontinue the medication before elective procedures.

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