New Study Reveals Benefits of GLP-1 Drugs, Reducing Post-Surgery Complications in Diabetes Patients

Diabetes is a chronic condition affecting millions worldwide, associated with complications that often reach far more than blood sugar levels. As surgeries become more frequent in managing diabetes-related conditions, there is an increased risk of post-surgery complications like infections, impaired wound healing, and blood clot formation. ^[1]

Now, a recent study in GLP-1 drugs offers a ray of hope, potentially improving surgical safety and recovery in diabetes patients. Dr. Spector and lead author Dr. Aschen, then a plastic surgery resident at NewYork Presbyterian/Weill Cornell Medical Center conducted a study to investigate the challenges diabetic patients with surgery face while using GLP-1 drugs.

Let's dig in: What are GLP-1 drugs? ^[1]

GLP-1 drugs (Glucagon-Like Peptide-1 Receptor Agonist) are among the most popular treatment options for persons with type 2 diabetes and obesity. 

• The core effect is achieved through its actions on the GLP-1 receptors in the pancreas, essentially stimulating insulin release from pancreatic islet β-cells and suppressing glucagon secretion from pancreatic islet α-cells, which contributes to the reduction in blood glucose levels in people with diabetes. 

• The weight loss effect is thought to be due to its activity on central and peripheral receptors in the brain and stomach, which also inhibits gastric emptying leading to feelings of satiety and lower appetite.^[2]

A groundbreaking study published online in the “Annals of Surgery” in December 2024, led by researchers from Weill Cornell Medicine, Columbia University Vagelos College of Physicians and Surgeons, and NewYork-Presbyterian suggests that, GLP-1 receptor agonist drugs such as ‘tirzepatide’ and ‘semaglutide’ may significantly reduce post-surgery complications in patients with diabetes. ^[2]

Key Findings of the Study: ^[2]

This large-scale study analyzed hospital records from 21,772 patients with diabetes, covering 74,425 surgical procedures from February 2020 to January 2023, and the investigators discovered that patients taking GLP-1 receptor agonists experienced.

• 12% Lower Risk of Hospital Readmission: Within a month of surgery

• 29% Lower Risk of Wound Reopening: Within six months of surgery.

• 56% Lower Risk of Hematoma Formation: Clotted blood at the surgical site

These findings were compared to those not on these medications.

The researchers examined de-identified electronic health records from Weill Cornell Medical Center and Columbia University Irving Medical Center. They followed up on the cases for six months and recorded rates of 30-day hospital readmission and post-surgical adverse events (wound reopening, hematoma, bleeding, and infection). They applied a “propensity matching” system to compare patients on GLP-1 drugs with similar patients not taking these medications. This approach minimized confounding factors, ensuring that differences in the outcome were likely related to the drugs themselves. ^[2]

To the researchers' surprise, the results showed that diabetic patients taking GLP-1 drugs were less likely to require hospital readmission, indicating fewer post-surgical issues than their counterparts. Whether or not the patients were using GLP-1 drugs, bleeding and infection occurred about as frequently. Also, the risk of wound reopening and hematoma formation was substantially lower among patients on GLP-1 drugs. ^[2]

Determining the exact mechanisms was beyond the study’s scope. However, Dr. Spector noted that previous studies and investigations show how GLP-1 drugs might promote wound healing in diabetes patients post-surgery: this might be due to improved blood sugar control, prevention of clotting, lowering inflammation, and enhanced blood vessel formation which helps to nourish and repair the damaged tissues. ^[2]

These findings could open up fresh possibilities for improving surgical recovery methods.

References:

1. "A Review of GLP‐1 Receptor Agonists in Type 2 Diabetes: A Focus on the Mechanism of Action of Once‐Weekly Agents." Journal of Clinical Pharmacy and Therapeutics. Accessed January 17, 2025. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpt.13230.

2. "Association of Perioperative Glucagon-Like Peptide-1 Receptor Agonist Use with Postoperative Outcomes." Annals of Surgery. Accessed January 17, 2025. https://journals.lww.com/annalsofsurgery/abstract/9900/association_of_perioperative_glucagon_like.1151.aspx.

By Dr Disha Merlyn Mathias