Nikki Sommer a nurse practitioner with Key West Surgical Group joined Good Morning Keys on Keys Talk 96.9/102.5FM yesterday morning for Medical Matters.
GLP1 medications have become very popular, but they need to be stopped before surgery.
Sommer said, “They have become very popular. Many people are on them, both for treating diabetes and for weight loss. So those are the medications, like Ozempic and Wegovy. Recently, in the last year or two, the American Society of Anesthesiologists, have stepped in because they are realizing that these GLP1s are affecting anesthesia and how anesthesia affects you. So it’s important to talk about these medications, because a lot of people when they’re on it for weight loss, they forget to disclose that on their medication list.”
What do GLP1s do?
Sommer said, “For diabetes, they get to control your blood sugar, but how they work is by slowing stomach emptying, reducing appetite and again, helping to control the blood sugar. So under the guidance of the ASA, food may be still left in the stomach, even if you fast. Normally, you fast before you have surgery, nothing to eat or drink after midnight. They say at least eight hours. However, because of the delayed gastric emptying in your stomach, you could still have food in your stomach when you show up for surgery the next day. If you’re on a GLP1 medication, this increases your risk of aspiration during the procedure, where food will get into your lungs or stomach, and then that could be very dangerous. It can cause pneumonia, and you can have trouble breathing after the procedure.”
What are the recommendations?
Sommer said, “Stop it the day of surgery, and they might have you hold it the day before. It really depends on where you’re having your surgery done and what the policy they’ve adapted for the anesthesia department with regards to these medications. For weekly GLP1 medications, those are the injections that you inject once a week. Most likely they’re going to tell you to hold it one week before. Currently, some institutions are actually recommending holding it for two weeks. So make sure that you talk to your doctor if you’re on these medications, if you’re due to have some type of surgical procedure, and figure out what the policy is. Also talk to your primary care provider, because if you’re on it for diabetes, you just might want to run a biome, just based on what your recent numbers were for keeping your diabetes under control. We’ve had this in the office, so this is on our questionnaire, we’ll say, list your medications, but now we specifically ask, are you taking any GLP1 medications? Because you can get them online, through online pharmacies for weight loss. So again, people don’t think of it as a regular, routine medication.”
What other dangers could being on GLP1s before surgery bring?
Sommer said, “If you show up for your surgery and you did not stop your GLP1, your surgery might be canceled. So you prepped for nothing. So especially if you’re going for a colonoscopy, you know how that goes. You do that whole prep. You drank clear liquids the day before, but you forgot to stop your GLP1 medication, guess what? They’re going to cancel your surgery, and you’re going to have to do it all over again. Anesthesia risk increases, like I said, higher chance of aspiration, and then that leads to post op complications. There is a thing where they’re concerned about the way you metabolize anesthesia, too, because it’s slowing everything down. So they’re going to treat the anesthesia will treat you as having a full stomach, even though you might have fasted because you didn’t stop this medication. If you are on a GLP1 for diabetes, make sure you talk to your provider and let them know that you need to stop it. Most diabetics, not all, because these GLP1s have been labeled the miracle drug of helping to control blood sugar. They get that hemoglobin A1C to where it needs to be. But a lot of times they’re on multiple medications. So they’re on oral medications as well as the weekly injection, so be aware that if you stop that your glucose could increase it, most likely will watch, watch your diet, discuss it with your primary care provider, let them know what’s going on, and see if there’s something else you need to do before you go for surgery.”
Honesty really is the best policy.
Sommer said, “Be honest with your provider. Don’t lie and say you didn’t take it and you did. All these things have happened. I’m not accusing anybody. It’s conversations that we’ve had in the office. Just be honest with the doctor and be aware that if you do take it, you’re going to have to stop it. And depending on where you’re having the surgery, it may be stopping it for one week or two.”
For more information on how Key West Surgical Group can help, click here: https://www.keywestsurgicalgroup.com/