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Related Concept Videos

Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

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 the...
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

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 manages...
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

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...
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

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.
Acarbose and miglitol are typically...
Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

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 significant...

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Updated: Jun 24, 2026

Multidisciplinary Approach to Obesity Management: A Case Report
05:10

Multidisciplinary Approach to Obesity Management: A Case Report

Published on: May 30, 2025

Perioperative Management of Patients using GLP-1 Receptor Agonists Current Evidence, Risks, and Practical

Uğur Serkan Çitilcioğlu1, Hatice Kaya Özdoğan1

  • 1University of Health Sciences Türkiye, Adana Faculty of Medicine, Adana City Training and Research Hospital, Department of Anaesthesiology and Reanimation, Adana, Türkiye.

Turkish Journal of Anaesthesiology and Reanimation
|June 23, 2026
PubMed
Summary

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) delay gastric emptying, potentially increasing risks during anesthesia. Current guidelines suggest individualized care and enhanced mitigation strategies over routine drug interruption for surgical patients.

Keywords:
Glucagon-like peptide-1 receptor agonistsanaesthesiagastric emptyingobesitypulmonary aspiration

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Mechanisms Underlying Gut Hormone Secretion Using the Isolated Perfused Rat Small Intestine
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Mechanisms Underlying Gut Hormone Secretion Using the Isolated Perfused Rat Small Intestine

Published on: February 26, 2019

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Last Updated: Jun 24, 2026

Multidisciplinary Approach to Obesity Management: A Case Report
05:10

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Published on: May 30, 2025

Mechanisms Underlying Gut Hormone Secretion Using the Isolated Perfused Rat Small Intestine
07:00

Mechanisms Underlying Gut Hormone Secretion Using the Isolated Perfused Rat Small Intestine

Published on: February 26, 2019

Area of Science:

  • Anesthesiology
  • Pharmacology
  • Endocrinology

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for diabetes and obesity.
  • These drugs are known to slow gastric emptying, raising concerns for surgical patients.
  • Potential for increased residual gastric contents (RGCs) and aspiration risk during anesthesia exists.

Purpose of the Study:

  • To review current evidence on GLP-1 RAs and perioperative gastric emptying.
  • To evaluate the implications for anesthesia and surgical patient management.
  • To inform updated guidelines and clinical practice regarding GLP-1 RA use in surgical settings.

Main Methods:

  • Systematic review of mechanistic studies, clinical investigations, and case reports.
  • Analysis of evidence regarding GLP-1 RA effects on gastric emptying.
  • Evaluation of current and emerging perioperative management strategies.

Main Results:

  • GLP-1 RAs consistently impair solid-phase gastric emptying, potentially increasing RGCs.
  • This effect can persist despite standard fasting and short drug interruptions.
  • Clinically apparent aspiration events are uncommon, but perioperative regurgitation is reported.

Conclusions:

  • An individualized, risk-adapted approach is recommended over routine GLP-1 RA interruption.
  • Enhanced perioperative mitigation strategies (diet, fasting, ultrasound, anesthesia choice) are crucial.
  • Further prospective studies are needed to define aspiration risk and establish evidence-based pathways.