Prevalence and predictors of residual gastric content in patients with type 2 diabetes on GLP ‐1 receptor agonists: A prospective observational study
Main finding · Increased residual gastric contentResult — go to the resultOdds ratio 2.52 95% CI 1.84–3.45Authors' conclusion
GLP-1 RA therapy is a potent, independent driver of significant gastric retention in patients with T2DM, persisting despite standard fasting. Crucially, the presence of diabetic retinopathy or nephropathy identifies a "double-hit" high-risk phenotype, where pharmacological delay interacts with microvascular burden. These findings suggest that current fasting protocols may be insufficient for these patients, necessitating individualized preoperative assessment based on microvascular status and dosing timing.
Study context
- Population
- Inpatients with T2D aged 18–80 years, BMI <40 kg/m², without conditions affecting gastric motility, Endocrinology Department of Ningbo No.2 Hospital, April–December 2024; gastric US after standard overnight fast237 [60.8%] male
- Participants
- 390 inpatients
- Exposure
- GLP-1 RA users vs non-users
- GLP-1 RA usersn = 224
- Outcome
- Prevalence of increased residual gastric content (solid content or clear fluid volume >1.5 mL/kg)
- Follow-up
- After standard overnight fast
Methodological detailssingle-centre, propensity score matching, inverse probability of treatment weighting
- Single-centre
- Propensity score matching
- Inverse probability of treatment weighting
Main finding
Increased residual gastric content
Odds ratio
2.52
95% CI 1.84–3.45
By group
As reported in the abstract
Observational data: associations, not effects.
Further findings
Risk factors for increased residual gastric content
- Diabetic retinopathy, OR
- 1.84 (95% CI 1.14-2.99)
- Diabetic kidney disease, OR
- 1.67 (95% CI 1.17-2.39)
- Independent risk factors
Days since last GLP-1 RA dose and increased residual gastric content (GLP-1 RA users)
- aOR per additional day (95% CI 0.65-0.90); odds reduced by 23%
- 0.77
Original publication
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