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In this file photo, a box of the diabetes drug Ozempic sits on the counter of a pharmacy on April 17, 2023 in Los Angeles, California.
Mario Tama | Getty Images
People on drugs for diabetes and weight loss such as Novo NordiskOzempic and Wegovy should stop taking them before elective surgery to reduce the risk of serious health complications, a prominent group of doctors has said.
The American Society of Anesthesiologiststhe organization of more than 53,000 doctors who practice anesthesiology has announced temporary instruction with this proposal late Thursday.
The guidelines are intended to help doctors treat patients taking those drugs who are scheduled for elective, non-emergency procedures such as kidney stone removal, joint replacement and cosmetic surgery.
The ASA said the guidelines reflect concerns about delayed gastric emptying, or when food sits in the stomach longer than usual. This is one of the effects of diabetes and weight loss drugs that mimic a hormone produced in the gut called GLP-1, ultimately suppressing a person’s appetite.
Delayed gastric emptying can cause patients undergoing anesthesia to experience nausea, vomiting and aspiration, which is when a person accidentally breathes food into the lungs instead of swallowing it, according to the ASA. Therefore, patients are usually required to fast before anesthesia for procedures.
The ASA has received anecdotal reports from across the U.S. that patients taking medications during general anesthesia and deep sedation may be at increased risk for these “serious” complications, group president Dr. Michael Champeau.
Ozempic and Wegovy are already connected with stomach problems such as diarrhea and constipation. But Champeau acknowledged that there is still a lack of scientific data on exactly how anesthesia affects these drugs, also known as GLP-1.
About every day 60,000 people across the country receive general anesthesia or pain-relieving drugs during surgeries and other procedures.
It’s not clear how many people take GLP-1 drugs every day, but their popularity has skyrocketed over the past year for weight loss. “miracles.” Now Novo Nordisk’s Ozempic and Wegovy are plagued by shortages across the country. They also face increasing competition from similar treatments such as Eli Lillyis Mounjaro.
According to ASA guidelines, people taking GLP-1 medications daily should skip treatment on the day of scheduled surgery. Those taking GLP-1 weekly should stop treatment a week before scheduled surgery, the group said.
Before surgery, physicians should consult with an endocrinologist to obtain instructions for patients taking GLP-1 for diabetes.
The group also said doctors should consider postponing a patient’s procedure if that person experiences nausea, vomiting or abdominal distension or pain on the day of the scheduled procedure.
If a patient does not have any of these symptoms but has not stopped using GLP-1 before surgery, doctors should consider using an ultrasound to check for a “full stomach.”
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