A Randomised Controlled Trial on Fasting and Gastric Contents in GLP-1 RA Patients
Glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications such as Ozempic, Wegovy, Mounjaro, and Trulicity have significantly improved the treatment of type 2 diabetes, obesity, and heart disease. However, these medications create a challenge before surgery. GLP-1 RAs can increase the risk of leftover food and liquid in the stomach, even if fasting rules are followed.
There is no clear, consistent guidance on how to manage these medications before surgery, mainly because there is no strong evidence from clinical studies on the best way to reduce these risks for patients. This randomised controlled trial will assess the effectiveness of different fasting recommendations using ultrasound assessment of the stomach contents.
Aim:
- To evaluate whether different fasting protocols affect residual gastric content among patients using once-weekly GLP-1 RA medications.
Status: Currently recruiting
Site: St Vincent’s Hospital Melbourne
Ethics: 322/24
ClinicalTrials.gov Registration
Principal Investigator: Prof Michelle Dowsey'
To be involved in this study, please contact Jasmin on 03 9231 1384
Eligibility
Inclusion
Adults ≥18 years of age
Have been using a once-weekly GLP-1 RA for at least one month
Willing to follow the instructions of fasting recommendations.
Exclusion
Has had a recent gastrointestinal bleed in the past month.
Has had previous surgery on lower oesophagus or stomach.
Has any known problems with upper digestive system, including hiatus hernia or stomach tumours.
Has a clinically diagnosed gastric emptying abnormality, such as gastroparesis.
Currently taking insulin.
Unable to lie on the right side for the gastric ultrasound.
Outcome Measures
Residual gastric contents
Solid content or thick fluids
Thirst
Hunger
Nausea
Fatigue
Anxiety
Intervention compliance
Time since last oral intake of solids and clear liquids