People with diabetes who take GLP-1 receptor agonist drugs, such as tirzepatide and semaglutidehave significantly lower rates of hospital readmissions, reopening of wounds and hematomas after undergoing surgery, according to a study led by researchers from the Weill Cornell Medical Center (USA), the Vagelos College of Physicians and Surgeons of Columbia University (USA) and New York Presbyterian Hospital (USA).
In depth
The study, published in the journal ‘Annals of Surgery‘, analyzed de-identified hospital records covering 74,425 surgical procedures in 21,772 patients with diabetes over a three-and-a-half-year period ending in July 2023. The researchers found that patients taking receptor agonists GLP-1known as GLP-1 drugs, had about a 12 percent lower risk of hospital readmission within one month of surgery, a 29 percent lower risk of wound reopening within six months of surgery and about a 56 percent lower risk of hematoma at the surgery site, in comparison with patients not taking such medications.
“These results, obtained in such a large number of patients and proceduressuggest that taking these drugs should not worsen post-surgical complications in general and could even reduce the probability of some of them“said lead author Jason Spector of New York-Presbyterian Hospital.
Pharmaceutical companies began developing GLP-1 drugs to treat diabetes in the early 1990s, and The first arrived at clinics in 2005. In 2014, the FDA approved its use to treat obesity. The drugs activate the GLP-1 receptor in cells of the pancreas and other organsstimulating the release of insulinwhich in turn reduces blood glucose and appetite.
More details
The recent increase in the use of GLP-1 drugs led to Spector and Seth Aschenfirst author and then a plastic surgery resident at New York Presbyterian Hospital, to see if diabetic patients undergoing surgery had more or fewer complications when they took them.
For their study, they and their colleagues examined deidentified electronic health recordsincluding all surgical procedures in patients with diabetes from February 2020 to July 2023 for which there were at least six months of tracking data.
They recorded the rates of 30-day hospital readmissions and four other postsurgical adverse events during this follow-up period, comparing these rates between patients. with and without active prescription of GLP-1 medications. They also used a propensity matching system to align patients taking GLP-1 drugs in each procedure with similar patients taking They were not taking the drugso that any difference in results would have more likely to be related to medication use.
To take into account
To the researchers’ surprise, the results showed that patients with diabetes who had been prescribed the drug GLP-1 were more likely modestly less than requiring hospital readmission within 30 days following the surgical intervention, which means fewer complications overall.
The researchers also they checked that, while bleeding and infections occurred with the same frequency whether patients were taking GLP-1 drugs or not, bruising and wound reopening occurred with noticeably less frequency: patients taking GLP-1 drugs -1 in the 180 days following surgery had only one 71 percent lower risk of wound reopening and 44 percent lower risk of hematoma than patients who were not taking prescription GLP-1 drugs.
Determining how GLP-1 drugs could exert such beneficial effects was outside the scope of the study. However, diabetes is known to carry an increased risk of impaired wound healing. The researchers found that it was improved glycemic control unlikely to mediate the positive effects on wound healing, since patients taking the drugs GLP-1 had higher mean blood glucose levels than control patients.
“Other studies have discovered that drugs can promote wound healing by preventing clotting, promoting the formation of blood vessels to help nourish tissues, reduce inflammation and other mechanisms” Spector noted.
Currently, he and his colleagues are conducting similar analyzes to see if GLP-1 drugs are associated with a greater or lesser risk of post-surgical complications in non-diabetic patients.
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