Glucagon-like peptide-1 receptor agonists and capsule endoscopy in patients with diabetes: a matched cohort study

Abstract

Background and AimsVideo capsule endoscopy (VCE) is valuable for assessing conditions like gastrointestinal bleeding, anemia, and inflammatory bowel disease. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are prescribed for diabetes and weight loss, with their pharmacologic effects including delaying gastric emptying. This study investigates the impact of GLP-1 RA usage on VCE outcomes in patients with diabetes. MethodsThis retrospective cohort study involves patients with diabetes undergoing VCE while on GLP-1 RA, matched 1:1 ratio with controls based on demographics and diabetes related factors, who are not on GLP-RA. The primary outcome is gastric transit time in VCE studies, with secondary outcome being incomplete small bowel evaluation and the small bowel transit time. ResultsIn the 68 GLP-1 RA patient cohort, five (7%) experienced VCE failure to pass through the stomach, while all controls passed successfully (p=0.06). GLP-1 RA patients had longer gastric transit time (99.3 ± 134.2 minutes) compared to controls (25.3 ± 31.6 minutes, p <0.001). Multivariate analysis revealed GLP-1 RA usage was associated with increased gastric transit time by 74.5 minutes (CI: 33.8-115.2, p <0.001) compared to controls, after adjusting on relevant factors. Sixteen GLP-1 RA patients (23.5%) experienced incomplete passage of the VCE through the small intestine, a significantly higher rate compared to three patients in the control group (4.4%) (p<0.01). ConclusionsGLP-1 RA usage is associated with prolonged gastric transit time and a higher rate of incomplete small bowel evaluation during VCE. Future studies may be crucial for evaluating strategies to mitigate these effects.