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Glucagon-like Receptor Agonists01:24

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Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

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α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
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Oral Hypoglycemic Agents: Glinides01:06

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Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
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Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Assessing the Impact of GLP-1R Agonists in Post-sinus Surgery Management.

David Hoying1, David C Kaelber2,3, Mohamad R Chaaban4

  • 1Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|December 7, 2025
PubMed
Summary

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) significantly reduced revision functional endoscopic sinus surgery (FESS) rates in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and obesity. GLP-1RA use also correlated with fewer biologic prescriptions post-surgery.

Keywords:
GLP‐1RATriNetXchronic rhinosinusitisobesity

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Area of Science:

  • Otolaryngology
  • Endocrinology
  • Pharmacology

Background:

  • Chronic rhinosinusitis with nasal polyps (CRSwNP) is frequently associated with obesity.
  • Weight loss medications, such as glucagon-like peptide-1 receptor agonists (GLP-1RAs), are increasingly used for obesity management.
  • The impact of GLP-1RAs on outcomes for CRSwNP patients undergoing surgery is not well understood.

Purpose of the Study:

  • To evaluate the effect of GLP-1RA prescription on revision functional endoscopic sinus surgery (FESS) rates.
  • To assess the impact of GLP-1RA prescription on the use of biologics after FESS in CRSwNP patients with obesity.

Main Methods:

  • Retrospective cohort analysis using the US Collaborative Network within the TriNetX Analytics platform.
  • Identified adult CRSwNP patients with obesity who had undergone prior FESS.
  • Compared revision surgery rates and first-time biologic prescriptions between patients with and without GLP-1RA prescriptions at 1- and 5-year follow-up.

Main Results:

  • After propensity matching (n=1391 per group), GLP-1RA use was associated with significantly lower revision FESS rates at 1-year (RR: 0.64) and 5-year (RR: 0.60) follow-up.
  • At 5-year follow-up, the GLP-1RA cohort showed a lower incidence of first-time biologic prescriptions (RR: 0.72).

Conclusions:

  • GLP-1RAs are associated with reduced rates of revision FESS in CRSwNP patients with obesity up to 5 years postoperatively.
  • Findings suggest GLP-1RAs may improve post-sinus surgery outcomes.
  • Further mechanistic and prospective studies are warranted to confirm these associations.