← Issue №14/ week of Oct 4, 2026/Endoscopy

The Impact of Glucagon-Like Peptide 1 Receptor Agonists Versus Diabetes Mellitus on Endoscopic Procedures: A Case-Control Study From a Large Tertiary Care Health System.

From GI Signals issue №14: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Endoscopy retrospective · n=1,054 · Oct 1, 2026 · J Clin Gastro · IF 2.9

The Impact of Glucagon-Like Peptide 1 Receptor Agonists Versus Diabetes Mellitus on Endoscopic Procedures: A Case-Control Study From a Large Tertiary Care Health System.

New evidence
Clinical takeawayCounsel patients on GLP1-RAs to adhere to a 24-hour liquid diet and bowel preparation before endoscopy to mitigate GFR risk, compared to diabetics off GLP1-RAs.
What it foundGLP1-RAs increased gastric food retention (GFR) to 4.7% vs 1% in matched diabetics off GLP1-RAs (P=0.03), but did not affect inadequate bowel preparation (16.5% vs 16.5%, P=1).
ContextConfirms GLP1-RAs independently increase GFR risk in adults 18+ undergoing outpatient EGD/colonoscopy, but challenges prior concerns about inadequate bowel preparation.
Emergingsuggested applicable standard· American Diabetes Association Professional Practice Committee, "6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026," Diabetes Care 2026;49(Supplement_1):S132-S149

No single passage of this standard matched the paper closely enough to quote, so none is shown. The standard is cited above.

Our full summary of this standard

Manage diabetes in GI/hepatology patients by individualizing the A1c target to the population, in cirrhosis, A1c is unreliable because altered red blood cell turnover typically underestimates glycemia, so set glycemic goals using blood glucose monitoring and/or CGM rather than a fixed A1c cutoff, and in diabetic gastroparesis individualize the target rather than applying a universal cutoff; ≤7% pre-bariatric, <6.5% pre-conception, while screening all T2DM for MASLD with FIB-4, screening T1DM for concurrent celiac disease, and screening for diabetic gastroparesis when chronic nausea, early satiety, or postprandial fullness are present. Evaluate new-onset DM after age 50 without obesity for a pancreatic cancer differential, and coordinate peri-procedural medication holds and multidisciplinary endocrinology involvement.

American Diabetes Association Professional Practice Committee, "6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026," Diabetes Care 2026;49(Supplement_1):S132-S149 · reviewed 2026-07-23 ↗
Bahdi F … Muthusamy VR · Journal of Clinical Gastroenterology · IF 2.9 · PubMed ↗Permalink
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