Glucagon-Like Peptide-1 Receptor Agonist Use and Postoperative Outcomes After Distal Radius Fracture Fixation in Adults With Type 2 Diabetes

Abstract

Background:

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for type 2 diabetes mellitus (T2DM), yet the perioperative safety profile in hand/wrist surgery remains incompletely defined. This study evaluated the association between preoperative GLP-1 RA exposure and postoperative complications and healthcare use following operative fixation of distal radius fractures in adults with T2DM.

Methods:

A retrospective cohort study was performed using the TriNetX Network (2018-2024). Adults with T2DM undergoing open surgical fixation of a distal radius fracture were categorized by active GLP-1 RA use within 180 days preoperatively. Propensity score matching (1:1) balanced demographics, fracture complexity, metabolic factors, diabetes severity, and medication use. Outcomes included 90-day medical complications, 180-day surgical complications, and healthcare use through 180 days. Odds ratios with 95% confidence intervals were estimated by logistic regression.

Results:

After matching, 1080 patients (540 per cohort) were included. Glucagon-like peptide-1 receptor agonist use was not associated with significant differences in composite 90-day medical complications or composite 180-day surgical complications. Individual adverse events were uncommon and did not differ between groups. Notably, GLP-1 RA use was associated with lower odds of emergency department visit and/or inpatient hospital readmission at 180 days, while use at 30 and 90 days was similar between cohorts.

Conclusions:

Among adults with T2DM undergoing operative fixation of distal radius fractures, preoperative GLP-1 RA exposure was not associated with increased medical or surgical complications and was associated with reduced 180-day healthcare use. These findings support the perioperative safety of GLP-1 RAs in this setting and warrant prospective validation.