Key result
Expert review provides algorithms for safe perioperative management of GLP-1RAs and SGLT2 inhibitors.
Why the study?
GLP-1 receptor-based agonists and SGLT2 inhibitors have important perioperative and periprocedural safety considerations, including risks of retained gastric contents, pulmonary aspiration, and diabetic ketoacidosis.
How should GLP-1RAs and SGLT2i be managed in perioperative and periprocedural settings to minimize risks of pulmonary aspiration and diabetic ketoacidosis?
How should GLP-1RAs and SGLT2i be managed in perioperative and periprocedural settings to minimize risks of pulmonary aspiration and diabetic ketoacidosis?
This review provides expert algorithms for managing GLP-1RAs and SGLT2i perioperatively to mitigate risks of pulmonary aspiration and diabetic ketoacidosis.
Answers are grounded in this paper and cite their sources.
May support cautious perioperative use of GLP-1RAs and SGLT2i; hypothesis-generating pending prospective validation.
The GLP-1 receptor-based agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2i) are major twenty first century breakthroughs in diabetes and obesity medicine but there are important safety considerations regarding the perioperative and periprocedural management of individuals who are treated with these agents. GLP-1RAs have been linked to an increased risk of retained gastric contents and pulmonary aspiration while SGLT2i can be associated with diabetic ketoacidosis. This manuscript provides a narrative review of the available evidence for perioperative and periprocedural risks in people prescribed GLP-1RAs and SGLT2i. The authors provide expert opinion-driven recommendations and algorithms on how to safely manage GLP-1RAs and SGLT2i under perioperative/periprocedural settings.
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Goldenberg et al. (2025) conducted a review in Diabetes and obesity requiring perioperative or periprocedural management. GLP-1 receptor-based agonists and SGLT2 inhibitors was evaluated. A narrative review provides expert opinion-driven recommendations and algorithms to safely manage GLP-1RAs and SGLT2 inhibitors in perioperative and periprocedural settings.
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