Things to Consider in Preoperative Management of Patients on GLP-1

Background: New classes of anti-hyperglycemic medications are being introduced for the management of diabetes mellitus. Endogenous glucagon-like peptide-1 (GLP-1) is a hormone that stimulates insulin production and reduces glucagon secretion. GLP-1 receptor agonists (GLP-1RAs) are associated with adverse gastrointestinal effects such as nausea, vomiting, diarrhea, constipation, abdominal distension, and abdominal pain. These medications can also cause delay in gastric emptying. Objective: To review the literature on GLP-1RAs, and to address the potential clinical controversies of these medications. Design: Commentary. Methods: The authors conducted a review of literature to evaluate the gastric effects of GLP-1RAs. Results: The literature review suggests that gastric emptying is delayed with the initiation of GLP-1RA therapy; however, there is variability in the methodology used to measure gastric emptying. Another confounding factor is that glycemic control can influence gastric emp more...