Should We Stop Glucagon-Like Peptide-1 Receptor Agonists Before Surgical or Endoscopic Procedures? Balancing Limited Evidence With Clinical Judgment.

IF 3.7 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Science and Technology Pub Date : 2025-07-01 Epub Date: 2024-03-11 DOI:10.1177/19322968241231565

Guillermo Umpierrez, Francisco J Pasquel, Elizabeth Duggan, Rodolfo J Galindo

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引用次数: 0

Abstract

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.

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手术或内窥镜操作前是否应该停用胰高血糖素样肽-1 受体激动剂？平衡有限证据与临床判断。

美国麻醉医师协会（ASA）特别工作组最近建议在手术前停用胰高血糖素样肽-1 受体激动剂（GLP-1 RA）药物，因为存在肺吸入的潜在风险。然而，支持这一建议的科学证据有限，而且停止 GLP-1 RA 治疗可能会恶化糖尿病患者的血糖控制。在我们等待更多关于围手术期 GLP-1 RA 治疗安全性数据的同时，我们建议采用其他多学科方法来管理接受择期手术的患者。我们需要开展良好的观察性和前瞻性研究，以确定接受 GLP-1 RA 治疗糖尿病和肥胖症的患者发生肺吸入的风险，以及糖尿病患者在择期手术前停用 GLP-1 RA 对血糖控制的短期影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Science and Technology Medicine-Internal Medicine

CiteScore

7.50

自引率

12.00%

发文量

148

期刊介绍： The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.