Is it necessary to stop glucagon-like peptide-1 receptor agonists prior to endoscopic procedure? A retrospective study  

作　　者：Haider Ghazanfar Nismat Javed Abeer Qasim Franklin Sosa Faryal Altaf Shazia Khan Jaydeep Mahasamudram Abhilasha Jyala Sameer Datta Kandhi Dongmin Shin Nikhitha Mantri Haozhe Sun Siddarth Hanumanthu Harish Patel Jasbir Makker Bhavna Balar Anil Dev Sridhar Chilimuri 

机构地区：[1]Division of Gastroenterology,Department of Internal Medicine,BronxCare Health System,Icahn School of Medicine at Mount Sinai,Bronx,NY 10457,United States [2]Department of Internal Medicine,BronxCare Health System,Icahn School of Medicine at Mount Sinai,Bronx,NY 10457,United States

出　　处：《World Journal of Gastroenterology》2024年第26期3221-3228,共8页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1 RA)are effective in diabetes and obesity,reducing hyperglycemia by increasing insulin release and delaying gastric emptying.However,they can cause gastroparesis,raising concerns about aspiration during procedures.Recent guidelines advise discontinuing GLP-1 RA before surgery to reduce the risk of pulmonary aspiration.AIM To evaluate the effect of GLP-1 RAs on gastric residual contents during endosco-pic procedures.METHODS A retrospective chart review at BronxCare Health System,New York,from January 2019 to October 2023,assessed gastric residue and aspiration in GLP-1 RA patients undergoing endoscopic procedures.Two groups were compared based on dietary status before the procedure.Data included demographics,symptoms of gastroparesis,opiate use,hemoglobin A1c,GLP-1 agonist indication,endo-scopic details,and aspiration occurrence.IBM SPSS was used for analysis,cal-culating means,standard deviations,and applying Pearson’s chi-square and t-tests for associations,with P<0.05 as being significant.RESULTS During the study,306 patients were included,with 41.2%on a clear liquid/low residue diet and 58.8%on a regular diet before endoscopy.Most patients(63.1%)were male,with a mean age of 60±12 years.The majority(85.6%)were on GLP-1 RAs for diabetes,and 10.1%reported digestive symptoms before endoscopy.Among those on a clear liquid diet,1.5%had residual food at endoscopy compared to 10%on a regular diet,which was statistically significant(P=0.03).Out of 31 patients with digestive symptoms,13%had residual food,all from the regular diet group(P=0.130).No complications were reported during or after the procedures.CONCLUSION The study reflects a significant rise in GLP-1 RA use for diabetes and obesity.A 24-hour liquid diet seems safe for endoscopic procedures without aspiration.Patients with upper gastrointestinal symptoms might have a higher residual food risk,though not statistically significant.Further research is needed to assess risks based on diabetes duration,g

关 键 词：Glucagon-like peptide-1 agonists GASTROPARESIS Endoscopic procedures Residual food COMPLICATIONS 

分 类 号：R61[医药卫生—外科学]