GLP-1 drugs may reduce surgical complications in diabetic patients

Diabetic patients taking GLP-1 receptor agonist drugs, such as tirzepatide and semaglutide, are less likely to be readmitted to the hospital or have less scar tissue after surgery, according to a large study led by researchers at Columbia University Vagelos College Weill Cornell Medicine. The incidence of recanalization and hematoma was significantly lower. Physicians and Surgeons and the New York Presbyterian Church.

of studyThe paper, published Dec. 20 in the Annals of Surgery, analyzed anonymized hospital records covering 74,425 surgical procedures on 21,772 diabetic patients over a three-and-a-half year period ending in July 2023. did.

Researchers found that patients taking GLP-1 receptor agonists, informally known as GLP-1 drugs, had an approximately 12% lower risk of readmission within a month after surgery; They found a 29% lower risk of the wound reopening within six months. The risk of hematoma (a collection of blood in tissue caused by bleeding) at the surgical site is reduced by about 56% compared to patients not taking these drugs.

“These findings from a very large number of patients and surgeries suggest that taking these drugs does not worsen postoperative complications overall and may even reduce the likelihood of some complications. “This suggests that,” said lead author Dr. Jason Spector '91. Professor of Surgery at Weill Cornell Medicine and in the Department of Plastic and Reconstructive Surgery at Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center.

Pharmaceutical companies began developing GLP-1 drugs to treat diabetes in the early 1990s, and the first drugs reached clinics in 2005. In 2014, the FDA approved the use of GLP-1 drugs to treat obesity. This drug activates GLP-1 receptors on cells in the pancreas and other organs, stimulating insulin release and lowering blood sugar levels and appetite.

In response to the recent surge in the use of GLP-1 drugs, Spector and lead author Seth Ashen, Ph.D., MBA '17, MD '18, then a plastic surgery resident at NewYork-Presbyterian/Weill Cornell Medical Center, We now check to see if diabetics are receiving treatment. When undergoing surgery, more or less complications will occur.

For the study, they and colleagues examined de-identified electronic medical records at NewYork-Presbyterian/Weill Cornell Medical Center and NewYork-Presbyterian/Columbia University Irving Medical Center. This includes all surgical procedures for patients with diabetes from February 2020 to July 2023. There was at least 6 months of follow-up data.

Researchers recorded 30-day readmission rates and four other postoperative adverse events during this follow-up period, and these were observed among patients who received and did not receive a prescription for an effective GLP-1 drug. The rates were compared. They also used a “propensity matching” system to line up patients taking a GLP-1 drug for each procedure with similar patients not taking that drug, and found that differences in results were related to drug use. We have made it more likely that you are doing so. .

To the researchers' surprise, the results showed that diabetic patients prescribed GLP-1 drugs were slightly less likely to require readmission within 30 days after surgery, which This suggests fewer overall complications.

The researchers also looked at specific complications such as wound recanalization, hematoma, bleeding, and infection. Researchers found that while bleeding and infection occurred about the same frequency whether or not patients were taking GLP-1 drugs, hematoma and wound recanalization occurred significantly less frequently. did. Only 71.1% of patients were taking GLP-1 drugs during the 180 days after surgery. There was a 44.0% reduction in the risk of wound reopening and hematoma compared to patients who did not receive GLP-1 medications.

Determining how GLP-1 drugs exert such beneficial effects was beyond the scope of the study. However, diabetes is known to increase the risk of impaired wound healing. The researchers found that improved blood sugar control was unlikely to have a positive effect on wound healing, as mean blood sugar levels in patients taking the GLP-1 drug were higher than in control patients. . Other studies have found that the drug may instead promote wound healing by preventing clotting, promoting blood vessel formation to nourish tissues, and reducing inflammation and other mechanisms. Spector said.

He and his colleagues are currently conducting a similar analysis to see whether GLP-1 drugs are associated with higher or lower risk of postoperative complications in non-diabetic patients.

Many of Weill Cornell Medicine's physicians and scientists maintain relationships and collaborate with outside organizations to foster scientific innovation and provide expert guidance. Institutions make these disclosures public to ensure transparency. Please see my profile for this information Dr. Jason Specter.

Jim Schnabel is a freelance writer for Weill Cornell Medicine.