Gastroparesis is a common complication in patients with diabetes mellitus (DM). During video capsule endoscopy (VCE), delayed gastric emptying may lead to incomplete examinations or require endoscopic placement of the capsule into the duodenum. GLP-1 receptor agonists (GLP-1RAs), increasingly used in the treatment of type 2 DM and obesity, are known to slow gastric motility. However, their effect on gastrointestinal transit times during VCE remains unclear. This study aimed to evaluate the association between GLP-1RA use and VCE outcomes in diabetic patients.

We performed a retrospective analysis of diabetic patients who underwent VCE. Patients were categorized based on GLP-1RA therapy. Gastric transit time (GTT) and small bowel transit time (SBTT) were recorded. Prolonged GTT was defined as capsule retention in the stomach for more than 60 minutes. Glycated hemoglobin (HbA1c) and potential confounders (age, sex, hospitalization, smoking status, use of psychotropics, hypothyroidism, and inflammatory bowel disease) were collected.

A total of 90 patients were included (50% male, mean age 70 ± 11 years), of whom 18 (20%) were receiving GLP-1RA.

Prolonged GTT was more frequent among GLP-1RA users (61.1% vs 34.7%, p=0.041). However, in multivariable logistic regression, this association was no longer statistically significant (OR 3.51, p=0.061), while HbA1c was the only independent predictor of delayed gastric emptying (OR 3.24 per 1% increase, p<0.001).

Median GTT and SBTT did not significantly differ between GLP-1RA and non–GLP-1RA groups (GTT: 49.0 vs 33.0 minutes, p=0.252; SBTT: 161.0 vs 203.1 minutes, p=0.558).

An association was observed between GLP-1RA use and prolonged GTT, although this effect did not persist after adjustment for clinical confounders, including HbA1c. Among all variables analyzed, HbA1c emerged as the only independent predictor of delayed gastric emptying. These findings suggest that prolonged GTT may be more closely related to poor glycemic control than to the use of GLP-1RA therapy itself. Optimizing glycemic control may therefore be a key strategy in reducing gastroparesis-related events during VCE in diabetic patients.