Related Experiment Video
Updated: Oct 27, 2026

Roux-en-Y Gastric Bypass Operation in Rats
Published on: June 11, 2012
Glucagon-Like Peptide-1 Receptor Agonist Use Is Associated With Increased Peripheral Nerve Compression After
Andrea Biaggi-Ondina1, Adam Boukind1, Lillee Izadi1
1Washington University School of Medicine, St. Louis, MO, USA.
Background:
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may reduce carpal tunnel syndrome (CTS) risk but are associated with acute compressive neuropathies after rapid weight loss ("slimmer's palsy"). This study evaluated upper-extremity nerve compression rates in patients with massive weight loss after bariatric surgery alone versus concurrent GLP-1RAs.
Methods:
A retrospective cohort study was conducted using the TriNetX US Collaborative Network. Adults who underwent bariatric surgery (January 2015-February 2026) were stratified by concurrent GLP-1RA therapy versus surgery alone. Propensity score matching (1:1) balanced baseline demographics and comorbidities. Primary outcomes were new CTS and cubital tunnel syndrome (CuTS). Secondary outcomes included surgical release and electrodiagnostic testing rates. Risk ratios (RRs) with 95% CIs were calculated.
Results:
In total, 11 158 patients were included in each cohort. The GLP-1RA group was younger (50.6 ± 12.2 vs 53.5 ± 14.3 years, P < .001) with lower BMI (39.9 ± 8.0 vs 42.6 ± 7.9 kg/m2, P < .001). Median follow-up duration was 365 days. The GLP-1RA group had a 63% higher risk of developing CTS (RR, 1.63; 95% CI, 1.26-2.10; P < .001) and a 110% higher risk of being diagnosed with CuTS (RR, 2.10; 95% CI, 1.35-3.27; P < .001). Carpal tunnel release rates were similar between groups (RR, 1.54; 95% CI, 0.77-3.09; P = .223). Glucagon-like peptide-1 receptor agonist users were more likely to undergo electrodiagnostic testing (RR, 1.43; 95% CI, 1.06-1.91; P = .017).
Conclusion:
Adjunctive GLP-1RA therapy was associated with increased diagnoses of CTS and CuTS without higher surgical rates, suggesting greater susceptibility to nerve compression. Further studies are needed to clarify mechanisms and guide clinical monitoring.
Related Concept Videos
Glucagon-like Receptor Agonists
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: Glinides
Hypoglycemia and Glucagon
Dipeptidyl Peptidase 4 Inhibitors
Oral Hypoglycemic Agents: Biguanides and Glitazones
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
Acarbose and miglitol are typically...