Risk Management

Weight Loss Drugs

March 7, 2024

Dear OMIC Insureds:

We bring this topic to your attention due to the rise in the use of glucagon-like peptide-1 (GLP-1) receptor agonists which are used for the treatment of Type 2 diabetes and for weight loss. GLP-1 agonists slow down the movement of food from the stomach into the small intestine, which can lead to an increased risk of regurgitation and pulmonary aspiration during surgery. The American Society of Anesthesiologists (ASA) consensus-based guidance is to hold GLP-1 agonists the day of the procedure for those patients taking a daily dose and hold for one week for patients taking a weekly dose. The current ASA fasting guidelines have not changed for patients taking this medication. ASA.

The risk management guidance is similar to the recommendations when holding medications prior to surgery when you are not the prescribing provider. For diabetic patients, we recommend you discuss with the prescribing provider and document the discussion and decision concerning the timing of discontinuing GLP-1 agonists pre-procedure to ensure no adverse effects, which could include hyperglycemia. This should also be discussed with the patient, documented, and included in pre-procedure and discharge instructions to ensure understanding of the risks and reasons for your hold recommendations and when to restart of the medication. In addition, rare side effects from these drugs can result in worsening diabetes-related retinopathy. Cleveland Clinic

If you have questions, contact us for confidential risk management advice at riskmanagement@omic.com or call us at 1-800-562-6642 and enter 4 for Risk Management.

Sincerely,

Jeannette Domask, MPH, CPHRM
OMIC Risk Manager