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Death (rare)

Users on Reddit, primarily in a medical professional context, have shared several anecdotal experiences of death (though considered rare) associated with GLP-1 medications. These instances are often linked to severe complications such as pancreatitis, bowel issues, and aspiration.

Experiences of Death on GLP-1 Medications:

  • Pancreatitis:

  • One user reported, "Death. Pancreatitis and they died about 3 days after their first dose. "[1] This was later specified as being with Wegovy. [2]

  • Another user stated, "GLP1 -> pancreatitis -> death (less than 2 weeks). "[3]

  • A medical article was referenced describing "acute necrotizing pancreatitis leading to death in a patient switching from Liraglutide to Tirzepatide I believe. They didn’t titrate. "[4]

  • An ICU professional shared, "I’ve had 2 die of pancreatitis in icu which is sobering. "[5]

  • Bowel Complications:

  • A user mentioned, "Saw a younger patient die. Constipation, obstruction, perforation. "[6]

  • Aspiration Pneumonia:

  • One account described a patient who "had self prescribed Ozempic, had silent aspirations that they weren't reporting at home, ended up getting aspiration pneumonia, intubated, ARDS, then passed away all within a week. "[7] This was attributed to "Likely delayed gastric emptying allowing significant reflux >> aspirations of gastric content. "[8]

  • Another user described a patient who "aspirate[d] during intubation 2/2 the delayed emptying, despite compliance with NPO. They ended up being fine, but pretty potentially devastating complication. I’m sure others have aspirated and not been fine…"[11]

  • Indirectly Related to GLP-1 (Hypoglycemia from Concomitant Insulin Mismanagement):

  • A user shared a case where a patient on Mounjaro, after significant improvement in blood glucose, "kept self-titrating insulin to maintain average BG <70, ultimately overdid it and collapsed at work, died before EMS arrived. "[9]


Remedies or Preventions Recommended/Implied:

  • Proper Titration and Switching:

  • When switching between GLP-1 drugs, it's crucial to start at the lowest dose and titrate up. For instance, "if you switch GLP-1 drugs you have to start at the bottom, so despite the Liraglutide dose of you switch to Tirzepatide you start at 2. 5mg/wk and tittate up. "[10]

  • Medical Supervision and Reporting Symptoms:

  • Avoiding self-prescription is critical, as highlighted by a fatal case involving self-prescribed Ozempic. [7]

  • Patients should report any adverse symptoms to their healthcare providers promptly.

  • Healthcare professionals are encouraged to report adverse events: "Hope y'all reporting these to medwatch or your appropriate AE reporting system. "[12]

  • Pre-Procedural Adjustments:

  • For patients undergoing procedures requiring anesthesia, discontinuing GLP-1s beforehand may be necessary due to delayed gastric emptying and aspiration risk. One institution's protocol was mentioned: "I think we require two weeks from last GLP1 injection before any procedure. "[13]

  • Awareness and Management of Known Risks:

  • Pancreatitis: The Wegovy warnings include: "Acute Pancreatitis: Has occurred in clinical trials. Discontinue promptly if pancreatitis is suspected. Do not restart if pancreatitis is confirmed (5. 2). "[14]

  • Constipation: Severe constipation can lead to serious outcomes like obstruction and perforation. [6] It's noted that, "Biggest warning is constipation actually, a lot of adults don't know it's not healthy to go every 3 days. "[14]

  • Hypoglycemia with Concomitant Medications: When GLP-1s are used with insulin or insulin secretagogues, there's an increased risk of hypoglycemia. The Wegovy warning states: "Hypoglycemia: Concomitant use with an insulin secretagogue or insulin may increase the risk of hypoglycemia, including severe hypoglycemia. Reducing the dose of insulin secretagogue or insulin may be necessary. "[14] Careful monitoring and dose adjustment of these concomitant medications are essential, as illustrated by a fatal case of insulin mismanagement.
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