Effects of glucagon-like peptide-1 receptor agonists on upper endoscopy in diabetic and nondiabetic patients

Abstract

Background and aims: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) promote weight loss by suppressing appetite, enhancing satiety, regulating glucose metabolism, and delaying gastric motility. We sought to determine whether GLP-1 RA use could affect medical procedures such as EGD.

Methods: We conducted a retrospective study of 35,183 patients who underwent EGD between 2019 and 2023, 922 of whom were using a GLP-1 RAs. Data were collected regarding demographics, diabetes status, retained gastric contents during EGD, incidence of aborted EGD, and necessity for repeat EGD.

Results: GLP-1 RA use was associated with a 4-fold increase in the retention of gastric contents (P < .0001), 4-fold higher rates of aborted EGD (P < .0001), and twice the likelihood of requiring repeat EGD (P = .0001), even after stratifying for the presence of diabetes.

Conclusions: GLP-1 RA use can lead to delayed gastric emptying, affecting EGD adequacy regardless of the presence of diabetes, and may warrant dose adjustment to improve the safety and efficacy of these procedures.