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Donal J. Buggy, M. Columb, J. Hermanides, M. Hollmann, Mark Coburn, Alexander Zarbock, Á. Caballero, Peter Paal, Sanja Granov, M. Krkušek, G. Samarani, T. Macharadze, Christoph Sponholz, E. Arnaoutoglou, P. Scanaill, Orit Nahtomi Shick, Matteo Bossolasco, J. Ilievska, Katarzyna Kotfis, A. Capelão, Daniela Ionescu, Sergey Efremov, P. Dunts, Unic Stojanovic, M. Soro, K. Saraçoğlu, Simon J. Howell, Paul Köglberger, G. Putzer, Barbara Ebner, M. Grünbart, H. Hoi, Simone Santosuosso, Senada Čaušević, M. Kovačević, Asmira Ljuca, Ilirijana Haxhibeqiri-Karabdić, S. Štraus, Sanja Berić, A. Martić, A. Horvat, Helena Krolo Videka, E. Dolenc, J. Peršec, M. Pražetina, N. Ivanov, Nataša Paklar, G. Grigolia, T. Samadashvili, Lasha Tabagari, G. Kachlishvili, Gabriel Janashvili, J. Roth, O. Sommerfeld, Lars Bergmann, Sebastian Schmid, Achilles Delis, Marie-Louise Fingerhut, T. Hilbert, Gregor Massoth, Claudia Neumann, Maria Wittmann, Christian Koch, M. T. Voelker, K. Stroumpoulis, Georgia Micha, G. Tsaousi, M. Ntalouka, D. Papaspyrou, S. Apostolaki, E. Anestiadou, O. Ioannidis, K. Zapsalis, L. Moran, Ahmed Abdelaatti, Mushtaq Ahmad, Donal J. Buggy, John Shaker, J. Hashmi, Kristiana Nali, Andrea Haren, S. Shinnors, D. Rafferty, K. Caulfield, Darren McMahon, Y. Gozal, Raed Jebrin, Waseem Moharib, A. Barranco, Paola Aceto, E. Luca, A. Cortegiani, S. Fiorelli, C. Menna, Matteo Tiracorrendo, A. Cotoia, A. Marra, Valentina Bellini, E. Bignami, Chiara Domaneschi, A. Hulst, L. Snel, Eelko K. de Groot, Robert Wilpe van, Y. Holtrust, L.M.J. Janssen, Emiel Caris, Seppe Koopman, Nieke Oversier, J. Postema, J. Rapon, Wouter van Bockel, Samuel Barclay, M. Godfried, Tomasz Czarnik, Agata Uchacz, Krzysztof Kusza, Maciej Arciszewski, M. Pankowiak, Bartosz Pawłowicz, Elżbieta Reszka, Justyna Zając, S. Baptista, Rita Pinto, Susana Andrez, Joana Azevedo, J. Cardoso, Morais Carina, Rodrigues Elsa, Joana Jones, F. Abelha, A. Lopes, Joana Mourão, L. Pereira, A. Santos, F. Bobirca, Dana Tomescu, Sergiu Sargarovschi, Romina-Marina Sima, N. Efremova, Alexey Ovezov, A. Hussain, Timur A. Dzhumatov, Yana Jumatava, V. Skvortsov, A. Trofimov, D. Unić-Stojanović, José María Cubero-Marcos, Gisela Myrella Hermenegildo Chávez, Ignacio Hinojal-Blanco, Á. Martínez-Díaz, M. Romero-González, Gerard Urrútia, Á. Becerra-Bolaños, Héctor Trujillo-Morales, Olga de la Varga-Martínez, Paula Gómez-Aguilar, A. Nieto-Moreno, Lerzan Doğan, D. Arça, A. Z. Turan Cıvraz, Emine Yurt, Derya Karasu, Tayfun Et, Gaye Boztepe Yılmaz, Osman Ekinci, Deepak Kurup, Sarah Barton, Tim Wilson, C. Thomas, J. Day, A. Hormis, D. Patel, V. Waugh, Rajesha Srinivasaiah, Nidhi Gautam, K. Miltsios, Sylvia Daamen, Pierre Harlet, Slama Farsi, Samaneh Sepehr, Sophie Debouche, M. VAN BELLE
0 1. 5. 2026.

Withholding or continuing glucose-lowering drugs for elective surgery in patients with type 2 diabetes mellitus: a secondary analysis of the MOPED international, prospective, observational study.

BACKGROUND There are conflicting guidelines on whether patients with type 2 diabetes mellitus should withhold or continue glucose-lowering drugs before surgery, especially newer agents. We tested the hypothesis that continuing glucose-lowering drugs increases days alive at home and out of hospital at 30 days (DAH-30). METHODS We performed a secondary analysis of a prospective, observational study in 21 European countries of patients with type 2 diabetes mellitus undergoing elective surgery. The primary outcome was DAH-30. The exposure of interest was the continuation or discontinuation of glucose-lowering drugs (metformin, sodium-glucose cotransporter 2 inhibitors [SGLT2i], glucagon-like peptide-1 receptor agonists [GLP-1 RA]). Median (interquartile [IQR]) values are shown. RESULTS Between January 2021 and December 2024, 5767 participants with type 2 diabetes mellitus (age 64 [range: 22-89] yr; 43% female) were enrolled from 89 centres, with 4988 (87%) undergoing elective surgery. For 3623/5767 (73%) participants receiving metformin, DAH-30 was higher (28 days [24-29]) in 421/3623 (12%) participants who continued metformin on the day of surgery compared with 27 days (23-29) in 3202 of 5767 (88%) participants who had not taken metformin (P=0.001). After adjusting for prespecified covariates, continuing metformin on the day of surgery remained associated with higher DAH-30 (0.47 days [95% confidence interval:0.01-0.93]; P=0.044). No association was found for either stopping/continuing SGLT2i (n=836 participants) or GLP-1 RA (n=304 participants) with DAH-30. CONCLUSIONS Continuing metformin during surgery among patients with type 2 diabetes mellitus was associated with marginally shorter DAH-30, but the sample size for participants receiving SGLT2i and GLP-1 RA therapy precluded any meaningful estimates. TRACKER ID ESA-IC_CTN_MOPED.


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