دورية أكاديمية
Is it necessary to stop glucagon-like peptide-1 receptor agonists prior to endoscopic procedure? A retrospective study.
| العنوان: | Is it necessary to stop glucagon-like peptide-1 receptor agonists prior to endoscopic procedure? A retrospective study. |
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| المؤلفون: | Ghazanfar H; Division of Gastroenterology, Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Javed N; Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Qasim A; Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Sosa F; Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Altaf F; Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Khan S; Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Mahasamudram J; Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Jyala A; Division of Gastroenterology, Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Kandhi SD; Division of Gastroenterology, Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States. skandhi@bronxcare.org., Shin D; Division of Gastroenterology, Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Mantri N; Division of Gastroenterology, Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Sun H; Division of Gastroenterology, Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Hanumanthu S; Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Patel H; Division of Gastroenterology, Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Makker J; Division of Gastroenterology, Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Balar B; Division of Gastroenterology, Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Dev A; Division of Gastroenterology, Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States., Chilimuri S; Division of Gastroenterology, Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, United States. |
| المصدر: | World journal of gastroenterology [World J Gastroenterol] 2024 Jul 14; Vol. 30 (26), pp. 3221-3228. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 100883448 Publication Model: Print Cited Medium: Internet ISSN: 2219-2840 (Electronic) Linking ISSN: 10079327 NLM ISO Abbreviation: World J Gastroenterol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group Original Publication: Beijing : WJG Press, c1998- |
| مواضيع طبية MeSH: | Gastroparesis*/epidemiology , Gastroparesis*/etiology , Gastroparesis*/prevention & control , Glucagon-Like Peptide-1 Receptor Agonists*/administration & dosage , Glucagon-Like Peptide-1 Receptor Agonists*/adverse effects, Aged ; Female ; Humans ; Male ; Middle Aged ; Diabetes Mellitus, Type 2/drug therapy ; Endoscopy, Gastrointestinal/adverse effects ; Endoscopy, Gastrointestinal/methods ; Gastric Emptying/drug effects ; Retrospective Studies |
| مستخلص: | Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are effective in diabetes and obesity, reducing hyperglycemia by increasing insulin release and delaying gastric emptying. However, they can cause gastroparesis, raising concerns about aspiration during procedures. Recent guidelines advise discontinuing GLP-1 RA before surgery to reduce the risk of pulmonary aspiration. Aim: To evaluate the effect of GLP-1 RAs on gastric residual contents during endoscopic procedures. Methods: A retrospective chart review at BronxCare Health System, New York, from January 2019 to October 2023, assessed gastric residue and aspiration in GLP-1 RA patients undergoing endoscopic procedures. Two groups were compared based on dietary status before the procedure. Data included demographics, symptoms of gastroparesis, opiate use, hemoglobin A1c, GLP-1 agonist indication, endoscopic details, and aspiration occurrence. IBM SPSS was used for analysis, calculating means, standard deviations, and applying Pearson's chi-square and t-tests for associations, with P < 0.05 as being significant. Results: During the study, 306 patients were included, with 41.2% on a clear liquid/low residue diet and 58.8% on a regular diet before endoscopy. Most patients (63.1%) were male, with a mean age of 60 ± 12 years. The majority (85.6%) were on GLP-1 RAs for diabetes, and 10.1% reported digestive symptoms before endoscopy. Among those on a clear liquid diet, 1.5% had residual food at endoscopy compared to 10% on a regular diet, which was statistically significant ( P = 0.03). Out of 31 patients with digestive symptoms, 13% had residual food, all from the regular diet group ( P = 0.130). No complications were reported during or after the procedures. Conclusion: The study reflects a significant rise in GLP-1 RA use for diabetes and obesity. A 24-hour liquid diet seems safe for endoscopic procedures without aspiration. Patients with upper gastrointestinal symptoms might have a higher residual food risk, though not statistically significant. Further research is needed to assess risks based on diabetes duration, gastroparesis, and GLP-1 RA dosing, aiming to minimize interruptions in therapy during procedures. Competing Interests: Conflict-of-interest statement: We have no financial relationships to disclose. (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.) |
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| فهرسة مساهمة: | Keywords: Complications; Endoscopic procedures; Gastroparesis; Glucagon-like peptide-1 agonists; Residual food |
| المشرفين على المادة: | 0 (Glucagon-Like Peptide-1 Receptor Agonists) |
| تواريخ الأحداث: | Date Created: 20240801 Date Completed: 20240801 Latest Revision: 20240823 |
| رمز التحديث: | 20240826 |
| مُعرف محوري في PubMed: | PMC11287410 |
| DOI: | 10.3748/wjg.v30.i26.3221 |
| PMID: | 39086638 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2219-2840 |
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| DOI: | 10.3748/wjg.v30.i26.3221 |