GLP-1s didn't increase risk of postop respiratory complications, study finds

Patients taking glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes before emergency surgery had a 3.5% incidence of postoperative respiratory complications compared with 4% among patients taking other diabetes medications.

Preoperative use of glucagon-like peptide-1 (GLP-1) receptor agonists among patients undergoing emergency surgery is not linked with an increased risk of postoperative respiratory complications, new research suggests.

This retrospective study used a database of patients on employer-sponsored health insurance plans to identify those with type 2 diabetes and a GLP-1 prescription fill who had undergone any of 13 emergency surgeries between January 2015 and December 2021. Researchers compared patients' outcomes with those who had at least one fill for a different diabetes drug. Findings were published by JAMA on April 22.

Of the 23,679 patients included, 3,502 were on a GLP-1 receptor agonist. These patients were more likely to be male, use more antidiabetic agents, and have obesity. Among patients taking GLP-1 receptor agonists, there was a 3.5% overall incidence of postoperative respiratory complications, compared with 4% among those not taking the medications (odds ratio [OR], 0.85 [95% CI, 0.70 to 1.04]; P=0.12). No significant difference in complication incidence was seen after adjustment (adjusted OR, 1.03 [95% CI, 0.82 to 1.29]; P=0.80).

One limitation to the study is that it only included commercially insured patients. Researchers were also unable to measure preoperative duration of GLP-1 receptor agonist therapy and did not have access to information about patient adherence. The study did not examine use of GLP-1 receptor agonists for weight loss alone.

Guidance published last year by the American Society of Anesthesiologists recommended preoperatively withholding GLP-1 receptor agonists, but the results of this study suggest that liberalizing preoperative use of the medication class should be considered, the study authors concluded.