ANAESTHESIOLOGY - GENERAL ANAESTHESIA / REVIEW ARTICLE
New therapeutic agents for type 2 diabetes: anaesthetic considerations. A narrative review
1
2nd Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Poland
2
Department of Diabetology and Internal Medicine, Medical University of Warsaw, Poland
3
Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, Site “Policlinico G. Rodolico”, Catania, Italy
4
Section of Anaesthesia, Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
Submission date: 2025-06-06
Final revision date: 2025-08-01
Acceptance date: 2025-08-02
Publication date: 2025-09-17
Corresponding author
Mateusz Zawadka
2nd Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland
2nd Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland
Anaesthesiol Intensive Ther 2025;57(1):231-238
KEYWORDS
perioperative managementSGLT-2 inhibitorsGLP-1RAGLP-1 receptor agonistsaspiration riskgastric ultrasoundGIP
TOPICS
ABSTRACT
An increasing number of patients treated with novel antidiabetic drugs, including glucagon-like-peptide-1 receptor agonists (GLP-1RA), dual glucose-dependent insulinotropic polypeptide receptor agonists and sodium-glucose cotransporter-2 (SGLT2) inhibitors, are presenting in the perioperative period. GLP-1RAs are known to delay gastric emptying, although current data remain preliminary and somewhat conflicting. SGLT2 inhibitors may be associated with euglycemic ketoacidosis in the perioperative period. To assess residual gastric content, gastric ultrasound may serve as a valuable tool in stratifying aspiration risk. Various recommendations are available for the perioperative management of patients on GLP-1RAs or SGLT2 inhibitors. These are based largely on expert opinion and multi-society consensus.
This review aims to summarise the key perioperative considerations related to these drug classes and to familiarise practitioners with their pharmacological profiles.
We highlight their potential adverse effects and present current recommendations from professional organisations to support safe and effective perioperative management.
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