Popular diabetes and weight loss drugs may carry ‘life-threatening’ risk for patients undergoing surgery

Experts are sounding the alarm on popular diabetes and weight loss drugs, including Ozempic, warning that the medication could lead to catastrophic complications for patients.

People on popular diabetes and weight loss drugs including Ozempic are being warned of increased risks for surgery and even catastrophic complications.

Anaesthetists say fasting before surgery may not be enough to ensure an empty stomach in those patients taking the drugs that were initially developed to treat type 2 diabetes.

The Australian and New Zealand College of Anaesthetists (ANZCA) says patients who have been using this class of drugs need to be aware of this side effect if they are preparing for an operation.

Writing in ANZCA’s Winter Bulletin, specialist anaesthetist Dr Ben Olesnicky also cautioned that patients should talk with their anaesthetist and other health specialists about whether or not they should stop taking the drug before their surgery as a precaution.

Dr Olesnicky, a member of ANZCA’s safety and quality committee, says the drugs can delay emptying of the stomach and this can potentially cause problems for people who have fasted before their operation.

He says while there is still limited data on how these drugs affect people having surgery, anecdotal evidence suggests it can cause problems.

Dr Olesnicky says the drugs work by helping the pancreas release the right amount of insulin when blood sugar levels are high and mimic the actions of a hormone called glucagon-like peptide (GLP).

These GLP analogues have several other side effects, including slowing stomach emptying and reducing appetite.

“General anaesthesia inhibits the body’s normal mechanisms to prevent stomach contents from refluxing back into the mouth and then moving into the lungs (aspiration),” Dr Olesnicky said.

“When a patient is properly fasted they have minimal amounts of stomach contents, but having a full stomach increases the risk of potentially life-threatening aspiration.”

Patients taking the drugs may be at increased risk of vomiting and aspirating food into the lungs and airways during general anaesthesia or deep sedation. Picture: Getty

Dr Olesnicky said the college was aware of cases involving two patients undergoing endoscopic gastroscopy who still had “significant gastric contents despite adequate fasting.”

“In some cases the slowing of stomach emptying can last for up to eight weeks but there is still a lack of evidence as to when gastric emptying returns to normal after a patient stops using the drug,” he says.

“The clinical significance of this is poorly understood. It may be prudent to cease these drugs, but consideration needs to be given to the duration of effect and the lack of evidence concerning when gastric emptying returns to normal following drug cessation.”

This week the American Society of Anesthesiologists (ASA) also issued a warning after receiving anecdotal reports from across the country that patients taking the drugs may be at increased risk of vomiting and aspirating food into the lungs and airways during general anaesthesia or deep sedation.

Calling for more research, the ASA also wants formal guidelines that would look at how long patients need to stop medication before surgery.

A spokesman for the maker of Ozempic, Novo Nordisk, said the decision to withhold Ozempic or the timing of Ozempic administration prior to anaesthesia should be made based on clinical judgment.

The spokesman said the decision should also involve assessment of the benefits versus risks in the specific patient including the patient’s pre-operative dosing, ability to tolerate Ozempic and pre-operative level of glycaemic control.

Originally published as Popular diabetes and weight loss drugs may carry ‘life-threatening’ risk for patients undergoing surgery