Managing noninsulin glucose-lowering medications before surgery

To the Editor: I am writing to suggest a correction to the review article by Drs. Morey-Vargas, Gossmann, Ketz, and Abdelmalak¹ published in the July issue. In the article, the authors state, “As such, the American Society of Anesthesiologists Task Force on Preoperative Fasting¹⁰ recommends holding GLP-1 agonists 1 week before scheduled elective procedures for patients on weekly dosing. For patients on daily dosing GLP-1 receptor agonists, it is appropriate to hold the medications on the day of the procedure. These recommendations are supported by some emerging data.”

However, in October 2024, the American Society of Anesthesiologists released a multisociety statement² that did away with this recommendation. I understand publishing takes time, and this article may have originally been submitted before the new guidance was published. However, as this article is specifically addressing noninsulin glycemic control agents, I think a correction or clarification should be published. I do appreciate that the authors commented on the likely changing recommendations.

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