Patients taking GLP-1 medications used to help manage Type 2 diabetes and support weight loss should always share their medication information with their primary care physician (PCP) and other healthcare providers they see.
Sharing medication information with all providers helps ensure patient safety, especially for surgery requiring anesthesia (medicine that prevents pain during surgery).
What are GLP-1s?
GLP-1s are a class of medications designed to help lower blood sugar and support weight loss.
There are many types of GLP-1 medications. Commonly prescribed GLP-1s include:
// Mounjaro®
// Ozempic®
// Rybelsus® (oral medication)
// Trulicity®
// Victoza® (oral medication)
// Wegovy®
Most are taken once a week by getting a shot in the belly, outer thigh, upper buttocks, or the back of the arm.
What are the risks of taking GLP-1s when a patient needs surgery?
For patients who need surgery and do not tell their healthcare providers that they are taking a GLP-1 and do not stop taking the medication, there is an increased risk of aspiration while under anesthesia.
Aspiration occurs when food, vomit, or another substance enters the lungs. Under anesthesia, a patient cannot clear the substance on their own. This can lead to complications, including death.
According to the Royal College of Anaesthetists 4th National Audit Project:
More than 50% of airway-related deaths in anesthesia were from aspiration.[1]
Why do patients taking GLP-1s have a risk for aspiration?
Side effects of GLP-1s include:
// Nausea
// Vomiting
// A delay in how long it takes a meal or drink to pass through the stomach
If a patient scheduled for surgery takes their GLP-1, there is a greater risk that food is still in their stomach. This food could come back up, but under anesthesia, a person cannot cough it up and get it out of their system. Instead, it can enter the lungs, leading to aspiration.
How can patients taking GLP-1s reduce the risk of aspiration?
Patients should always share all the medications they are taking with every healthcare provider they visit.
How long should a patient hold their GLP-1 medication before surgery?
The time a person should stop taking their GLP-1 depends on the type of medication a patient takes. Patients should work with their healthcare provider to know when to stop taking their GLP-1 before surgery.
Why is it important for patients to tell their healthcare providers about their medications?
Patients receive care and medication from medical spas, clinics, urgent care, hospitals, and many providers—nurse practitioners, cardiologists, and oncologists. What happens in one visit with one provider is not always available to the next provider in the next location.
When healthcare providers know what medications their patients are taking, they can:
// Address potential adverse medication interactions.
// Ensure patients take the right steps to prepare for medical procedures, like surgery.
What is UHC doing to prevent GLP-1 medication use before surgery?
Our team is always working to identify ways to improve patient care, safety, and the healthcare experience. We recognized the safety concern for our patients and the inconvenience it was causing.
To remedy the situation, the UHC team has taken several actions:
- Updating hospital protocols to ensure that all surgical staff ask patients about their medications, including GLP-1s, and inform patients about the need to stop taking GLP-1s before getting surgery requiring anesthesia.
- Educating patients on sharing their medication information with their healthcare providers.
- Working with local clinics and medical spas prescribing GLP-1s to inform their patients that GLP-1s are medication and pose certain risks if not stopped before surgery.
- Informing the media to create awareness about the importance of patients disclosing their medications.
Watch the latest House Call video on GLP-1 medication with Dr. Scott Ross, Medical Director of Anesthesiology at WVU Medicine United Hospital Center: https://uhchousecall.com/videos/glp-1s-part-i/.
[1] https://academic.oup.com/bjaed/article/14/4/171/293792
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