GLP-1 Receptor Agonists: Rewriting the Perioperative Fasting Guidelines

Abstract

Type 2 diabetes and obesity together have grown into one of the biggest public health and economic burdens of our time. Glucagon-like peptide-1 (GLP-1) receptor agonists—semaglutide (Wegovy) and tirzepatide (Mounjaro) among them are now widely prescribed for both diabetes control and weight loss. Their growing popularity has created a fresh challenge for anaesthetists: the existing perioperative fasting guidelines need to be rewritten to keep pace.These drugs slow gastric emptying, and several case reports have shown that patients can still have significant residual gastric content even after following standard nil-by-mouth (NBM) protocols [1,2]