Holding GLP-1 Drugs Before Endoscopy: A Randomized Trial on Gastric Volume

Incretin-based therapies, such as GLP-1 receptor agonists, are highly effective treatments for Type 2 Diabetes Mellitus and obesity. A known side effect of these medications is delayed gastric emptying, which can increase the risk of residual gastric volume (RGV) during medical procedures like upper endoscopy. This study aims to determine if temporarily stopping incretin-based therapies before an upper endoscopy reduces the risk of complications related to residual stomach contents.

As this randomized trial recently completed data collection (expected completion May 20, 2025), the specific results regarding the impact of holding incretin-based therapies on Residual Gastric Volume (RGV) are currently pending publication. The study's primary objective is to quantify whether holding these medications significantly reduces the likelihood of RGV that could impede adequate endoscopic examination or necessitate premature termination of the procedure. Researchers are also investigating if holding medication decreases the need for endotracheal intubation due to stomach contents and the occurrence of aspiration events requiring extended observation or hospital admission. The most critical finding, once published, will reveal the quantitative difference in clinically relevant Residual Gastric Volume between patients who held their GLP-1 medication and those who continued it, directly informing pre-procedural guidelines. Secondary outcomes will include the presence of any solid food, moderate liquid content, or an increased RGV defined as any solid content or fluid content exceeding 0.8 mL/Kg.