GLP-1s: The Impact on Foot and Ankle

Novo Nordisk’s semaglutide, the generic form of Ozempic, Wegovy and Rybelsus, was the most prescribed GLP-1 medication in 2023, making up more than 88% of all new prescriptions. 2024 Q2 sales for Novo Nordisk semaglutide was $4.2 billion.

GLP’s and anesthesia

GLP-1 medications should be stopped one week before surgery to allow for gastric emptying. A notable difference was found, as 59% of patients on GLP-1s had increased residual gastric contents, compared to only 19% of those not using these medications. The American Society of Anesthesiologists recommends stopping GLP-1s one week prior to surgery. 

Higher risk of infection with GLP-1s

At the 2024 AOFAS annual meeting, Levidy et al. presented a study comparing propensity-matched cohorts based on whether they had taken a GLP-1 with a year prior to surgery. One key outcome was the rate of postoperative infections. The study found that patients treated with GLP-1 agonists had a significantly higher infection rate of 9% compared to 5.6% in patients who did not take GLP-1 agonists.