Managing patients taking glucagon-like peptide-1 receptor agonists: proceed with caution

The use of glucagon-like peptide-1 (GLP-1) receptor agonists for managing type 2 diabetes mellitus has increased, but concerns have arisen about potential risks of perioperative pulmonary aspiration. A recent study by Huang and colleagues analysed the US Food and Drug Administration Adverse Event Reporting System database, and found a significant association between GLP-1 receptor agonist use and impaired gastric emptying events, which can lead to aspiration. Recent guidelines suggest that most patients can continue taking GLP-1 receptor agonists before surgery, and those at high risk for gastrointestinal issues should follow a 24-hour liquid diet beforehand, but determining which patients are at high risk for aspiration remains a challenge for clinicians.