Perioperative Management of Patients on GLP-1 Receptor Agonists: Clinical Implications and Best Practices

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for type 2 diabetes mellitus (T2DM), obesity, and cardiovascular risk reduction. As these medications become more common, perioperative clinicians must understand their implications. Recent data suggest GLP-1 RAs may delay gastric emptying and increase the risk of aspiration during anesthesia. This narrative review summarizes current evidence, highlights clinical guidelines, and offers a perioperative management framework for patients on GLP-1 RAs, including semaglutide, liraglutide, dulaglutide, and others. We also present a clinical decision table to guide perioperative medication holds and patient risk stratification.