P1439 - Frequency of GLP-1 Analog Use in Diabetic Patients With Delayed GES and Their Demographic Profile

M. Ammar Kalas, MD¹, The Dang, DO¹, Gian Galura, MD¹, Luis Alvarado, MS², Abhizith Deoker, MD³, Richard McCallum, MD^1
1Texas Tech University Health Sciences Center at El Paso, El Paso, TX; ²Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, TX; ³Texas Tech Health Sciences Center, El Paso, TX

Introduction: Gastroparesis (GP) is a disease characterized by delayed gastric emptying (GE) in the absence of gastrointestinal obstruction and is dominated by females. The etiologies of GP range from Diabetes mellitus (DM), post-surgical causes, medications, systemic diseases such as Scleroderma, Parkinson’s, or can be idiopathic. Glucagon-like peptide-1 analogs (GLP-1) have surged in popularity owing to their convenient weekly dosing in addition to their cardioprotective properties through modifications on glycemic control, weight loss, and improvement in blood pressures. However, by activating GLP-1 receptors, a decrease in antro-duodenal motility and increased pyloric sphincter pressure results in a slowing in GE. Therefore, our goal was to identify diabetic patients who underwent a GES while on GLP-1 analogs and hence determine the potential for GP overdiagnosis due to likely iatrogenic GP.

Methods: A retrospective analysis of all patients aged 18 and older who underwent gastric emptying study (GES) at the University Medical Center of El Paso between January 2019 and January 2021 was conducted and 383 patients were identified. Data was analyzed based on whether or not patients were receiving a GLP-1 analog at the time of their GES study. Variables were compared using a Chi Square test, Fisher’s exact test, and an un-paired t-test. Relative risk (RR), 95% confidence intervals (C.I.) and p-values were used to describe the analysis. P-values were considered significant at 5% level of significance. All data analysis and management were conducted using Stata V.15.1.

Results: Patients on a GLP-1 analog were more likely to have an delayed GES. Out of a total of 383 patients, 151 were identified with delayed GES, 85 of whom were diabetic and specifically 24 having a delayed GES while on a GLP-1 analog. 4 patients with delayed GE normalized their study following discontinuation of GLP-1 analogs on repeat GES. Statistical analysis found that administration of GLP-1 to patients with a history of 10 years or less of DM, older age ( > 50 years), or female were at higher risk for an abnormal GES.

Discussion: Our study shows that 28% of diabetics diagnosed with GP were receiving a GLP-1 analog and were statistically more likely be females with DM for < 10 years. GLP-1 analog induced GP is reversible when stopping the agent in contrast to true diabetic GP which is regarded as irreversible. Misdiagnosis results in unnecessary burden on the patient both in terms of quality of life and economics.


Disclosures:
M. Ammar Kalas indicated no relevant financial relationships.
The Dang indicated no relevant financial relationships.
Gian Galura indicated no relevant financial relationships.
Luis Alvarado indicated no relevant financial relationships.
Abhizith Deoker indicated no relevant financial relationships.
Richard McCallum indicated no relevant financial relationships.


M. Ammar Kalas, MD¹, The Dang, DO¹, Gian Galura, MD¹, Luis Alvarado, MS², Abhizith Deoker, MD³, Richard McCallum, MD¹. P1439 - Frequency of GLP-1 Analog Use in Diabetic Patients With Delayed GES and Their Demographic Profile, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.