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2.2 Indications The currently approved indications for these agents include: Type 2 diabetes mellitus Overweight and obesity Beyond diabetes and obesity, further indications under investigation for GLP1 RAs include: Osteoarthritis Obstructive sleep apnea Metabolic dysfunction-associated steatotic liver disease Metabolic dysfunction-associated steatohepatitis 2.3 Benefits and Harms of Continuation/Discontinuation in the Perioperative Period: 2.3.1 Benefits: According to the guidelines, the acute use of these drugs may offer benefits based on published data: Improved perioperative glycemic control Lower postoperative insulin requirements Reduced risk of hypoglycemia These benefits may lead to reduced complications associated with hyperglycemia (such as a shorter hospital stay, fewer surgical site infections, less acute kidney injury, fewer acute coronary syndromes, reduced critical care admissions, and shorter durations on a ventilator) Improved cardiovascular outcomes 2.3.2 Harms There is an increased risk of pulmonary aspiration

Summarized below are major CVOTs that have been published since the issuance of the FDA guidance, which will continue to inform treatment decisions for patients with diabetes with or at high risk for CVD

Increase side-effects when used without supervised dose titration

8 As these therapies advance through the pipeline, they may complement or enhance current GLP1based strategies