Gastroparesis induced by glucagon-like peptide-1 receptor agonists: A systematic review of clinical features, diagnosis, management, and outcomes
Abstract
Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for the treatment of type 2 diabetes mellitus and obesity. Although gastrointestinal adverse effects are common, gastroparesis is an under-recognised but clinically important complication. This systematic review summarises published evidence on the presentation, diagnosis, management, and outcomes of gastroparesis associated with GLP-1RA therapy in real-world clinical practice.
Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Embase, Scopus, and Web of Science were searched from inception to October 2025 for reports of symptomatic gastroparesis associated with GLP-1RA use. Eligible studies included case reports, case series, observational studies, and clinical trials involving adults treated with GLP-1RAs for diabetes or weight loss. Data extraction focused on patient characteristics, GLP-1RA exposure, clinical presentation, diagnostic findings, management strategies, and outcomes. Methodological quality was assessed using the Joanna Briggs Institute checklist for case reports.
Results: Twelve case reports describing 13 patients met inclusion criteria. Most patients were female and had type 2 diabetes mellitus, though cases also occurred in non-diabetic individuals. Semaglutide was the most frequently implicated agent, followed by liraglutide, dulaglutide, and exenatide. Symptom onset ranged from hours to several months after treatment initiation,…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 13 participants or records.
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