Assistance to a health practitioner: how to prepare a patient receiving glucagon-like peptide-1 receptor agonists for endoscopic and sur- gical interventions?

Actually, the perioperative management of patients receiving glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is a matter of lively discussions. GLP-1 RAs, known for their significant organ protective effects and widespread use in patients with type 2 diabetes and obesity, can slow gastrointestinal motility. The review systematically analyzes literature data on perioperative use of GLP-1 RAs focusing on the incidence and nature of gastrointestinal adverse events (AEs). Also, risks of aspiration and improper intestinal preparation during fibrocolonoscopy are discussed. The analysis of risk factors predisposing to delayed gastrointestinal transit and aspiration (including specific pharmacokinetics of various GLP-1 RAs) is reported. The inconsistencies in international guidelines highlight the need for a differentiated approach to obese patients and those with type 2 diabetes mellitus receiving GLP-1 RAs. Potential withdrawal of GLP-1 RAs before an endoscopic or surgical intervention and the therapy reinitiation are under discussion. In conclusion, the paper provides updated recommendations to improve preparation of patients receiving GLP-1 RAs for endoscopic and surgical interventions. Keywords: glucagon-like peptide 1 receptor agonists, diabetes mellitus, obesity, surgical intervention, gastric emptying, pulmonary aspiration, perioperative period For citation: Karonova T.L., Mikhailova A.A., Murasheva A.V., Laevskaya M.Yu., Shlyakhto E.V. Assistance to a health practitioner: how to prepare a patient receiving glucagon-like peptide-1 receptor agonists for endoscopic and surgical interventions? RMJ. 2025;2:21–26. DOI: 10.32364/2225-2282-2025-2-4