What Doctors Need to Know When Performing Procedures on Patients Taking Ozempic and Other GLP-1 Drugs | Research

The takeaway

As GLP-1 agonist use surges, interventional radiologists must adapt their procedural practices because these drugs affect blood sugar levels and stomach emptying, creating new risks during sedation.

Rapidly increasing GLP-1 use
Interventional radiologists will increasingly encounter GLP-1 patients requiring procedures with sedation, but no IR-specific guidelines exist

What the researchers found

The review identifies two primary peri-procedural concerns for patients taking GLP-1 receptor agonists:

1. Delayed gastric emptying — GLP-1 agonists slow the rate at which the stomach empties, meaning standard fasting protocols may not adequately ensure an empty stomach before conscious sedation, increasing the risk of aspiration (inhaling stomach contents into the lungs)

2. Blood sugar effects — These drugs lower fasting glucose levels, which has implications for blood sugar management during and after procedures, particularly in diabetic patients who may also be on insulin or other hypoglycemic agents

The review emphasizes that current interventional radiology guidelines do not adequately address these GLP-1-specific risks and calls for IR-specific guidance to be developed.

Why it matters

With GLP-1 agonist prescriptions skyrocketing for both diabetes and weight management, virtually every medical specialty is now encountering patients on these drugs. The sedation safety concern is particularly urgent because delayed gastric emptying is a well-documented effect of GLP-1 agonists, and aspiration during sedation can be life-threatening. Updated pre-procedure protocols could prevent serious complications as more patients present for interventional radiology procedures while taking these medications.

How the study worked

This is a narrative review discussing the pharmacological effects of GLP-1 receptor agonists and their implications for interventional radiology practice. The authors synthesize existing literature on GLP-1 drug pharmacology, gastric emptying effects, and peri-procedural management to identify gaps in current clinical guidelines.

What this study cannot tell us

This is a narrative review focused on interventional radiology, and the specific evidence base for aspiration risk in GLP-1 patients undergoing IR procedures is limited. Most sedation safety data comes from surgical and anesthesia literature. The degree of gastric emptying delay varies between different GLP-1 agonists, doses, and individual patients, making blanket recommendations difficult. The review does not present original data or systematic evidence synthesis.

How to read the evidence

This is a narrative review providing clinical guidance based on known pharmacological effects of GLP-1 agonists. It does not present original clinical data or systematic evidence synthesis. The recommendations are based on pharmacological reasoning and extrapolation from related specialties rather than IR-specific outcome studies.

When this study was published

Published in 2025, this is a timely review addressing an urgent clinical issue as GLP-1 agonist prescriptions continue to surge worldwide. The guidance is highly relevant to current clinical practice.

The bigger picture

This review is part of a broader reckoning across medicine about the system-wide effects of the GLP-1 agonist revolution. Similar concerns have been raised by anesthesiologists, gastroenterologists, and surgeons. The American Society of Anesthesiologists has already issued guidance on GLP-1 drugs and procedural sedation. As these drugs move into even wider use — potentially for cardiovascular protection, kidney disease, and addiction — every procedural specialty will need updated protocols.

Questions still open

Should patients on GLP-1 agonists be required to fast for longer periods before procedures involving sedation?
Does temporarily stopping GLP-1 agonists before procedures adequately reverse the delayed gastric emptying effect?
Are certain GLP-1 agonists (e.g., short-acting vs. long-acting) safer for patients undergoing sedated procedures?

Common questions

Why do GLP-1 drugs create risks during medical procedures?

GLP-1 agonists like semaglutide (Ozempic) and liraglutide slow down how quickly the stomach empties food. When patients need sedation for a procedure, doctors assume fasting before the procedure means the stomach is empty. But GLP-1 drugs can keep food in the stomach much longer than normal, creating a risk that patients could vomit and inhale stomach contents into their lungs while sedated — a dangerous complication called aspiration.

Should patients stop taking GLP-1 drugs before a procedure?

This is exactly the question the review highlights as needing clearer guidelines. Some anesthesia organizations have recommended temporarily holding GLP-1 agonists before sedated procedures, but the optimal timing varies by drug type (daily vs. weekly formulations) and there is limited direct evidence. The review calls for specialty-specific protocols so that interventional radiologists and other proceduralists can make informed decisions for each patient.

Read the original research

The Ozempic Generation: What the Interventional Radiologist Needs to Know About GLP-1 Agonists.

Journal of medical imaging and radiation oncology, 69(8), 836-843

View on PubMed ↗Publisher’s paper ↗

Citation

Wani, Suhail; Findakly, Salam; Phan, Tuan; Lukies, Matthew W; Goh, Gerard S; Venn, Georgina; Joseph, Tim; Koukounaras, Jim; Clements, Warren. (2025). The Ozempic Generation: What the Interventional Radiologist Needs to Know About GLP-1 Agonists.. Journal of medical imaging and radiation oncology, 69(8), 836-843. https://doi.org/10.1111/1754-9485.70045