any glp 1 oral GLP-1 receptor agonists are generating a great deal of excitement as a potential inflection point in diabetes and obesity care. Amid the enthusiasm, however, a quieter and clinically important issue is US FDA accepts Novo Nordisk's

Recommendations for the peri-operative management of patients taking glucagon-like peptide-1 receptor agonists and glucose-dependent insulinotropic peptide [1] : The risk of pulmonary aspiration and mitigation strategies should be discussed with the patient using a shared decision-making approach." "Patients should continue to take glucagon-like peptide-1 receptor agonists throughout the perioperative period." "Patients and clinicians should adhere to recommended fasting guidelines." "Upper gastrointestinal symptoms alone should not be used to determine gastric content." "Regional anaesthesia should be considered as the primary anaesthetic technique, if appropriate." "Point-of-care gastric ultrasound should be considered before induction of anaesthesia to facilitate risk stratification, if appropriate." "Individualised pulmonary aspiration risk assessment should be completed, accounting for drug, patient and procedural factors." "Anaesthesia and airway management should aim to reduce the risk of pulmonary aspiration on induction of anaesthesia, during maintenance and after emergence of anaesthesia

Peptide therapy helps restore these essential building blocks, promoting optimal health and vitality

Janssen I, et al

This is because vitamin B12 is primarily in animal-based foods