If the medication is prescribed as daily oral or subcutaneous administration, we recommend pausing GLP-1 agonists on the day of the procedure. (CPS)

There is no evidence to show that stopping these medications even 1 week before the procedure will eliminate the risk of delayed gastric emptying, despite following the usual fasting timing for surgery. (CPS)

A clear fluid diet should be encouraged 24 h before any procedure in patients taking GLP-1 agonists. (CPS)

All patients taking GLP-1 agonists should be considered as at risk of having a full stomach despite a lack of gastrointestinal symptoms. (CPS)

Whenever possible, a gastric ultrasound should be performed. If gastric contents are found by ultrasound and these are considered as a high risk for aspiration, patients should be counselled about this risk before deciding to proceed with sedation/general anaesthesia. (CPS)

If the procedure is of such urgency that postponement is not desirable, endotracheal intubation by rapid sequence induction/intubation is advised. (CPS)

SGLT2 inhibitors (SGLT2i) drugs should be withheld for 3 to 4 days before elective procedures to reduce the risk of euglycemic diabetic ketoacidosis. (CPS)

Patients taking SGLT2i medications should consume clear fluids approximately 2 h before the procedure to keep regular hydration. (CPS)

Euglycemic diabetic ketoacidosis should be suspected in this category of patients, and blood β-hydroxybutyrate (BOHB) is a functional confirmatory test. (CPS)

If a patient taking SGLT2i drugs did not discontinue the medication in time, dehydration caused by bowel preparation for endoscopy can increase the ketone levels, and the patient should be adequately hydrated before leaving the hospital. (CPS)