# GLP-1 Drugs and Rotator Cuff Repair Complications in Type 2 Diabetes | This GLP Among 5,876 rotator cuff repairs, raw odds ratios of 3.85, 2.20 and 1.97 against GLP-1 users all vanished once the comparison was adjusted. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/glp1-shoulder-surgery-adjustment Updated: 2026-09-18 Published: 2026-09-16 [← Research](https://thisglp.com/research) Evidence # GLP-1 Drugs and Rotator Cuff Repair Complications in Type 2 Diabetes GLP-1 users looked worse on three outcomes after shoulder surgery. Then the authors made the groups comparable and all three differences disappeared. [This GLP Editorial Team](https://thisglp.com/about)September 20265 min readUpdated September 2026 Before adjustment — odds ratio against no GLP-1 · urinary tract infection · 3.85 · stiffness · 2.20 · respiratory · 1.97 · After adjustment: none of them survived. **Research, not medical advice.** This GLP is independent and educational. Nothing here is a substitute for individualized care from a licensed clinician, and reading it creates no doctor–patient relationship. Talk to your own provider before starting, stopping, or changing any medication, peptide, or therapy. See our [methodology](https://thisglp.com/methodology) and [terms](https://thisglp.com/terms). ## Key takeaways - 5,876 adults with type 2 diabetes had a rotator cuff repair. 233 were on a GLP-1 beforehand. - Raw comparison: respiratory complications OR 1.97, urinary tract infection OR 3.85, stiffness OR 2.20. - After inverse propensity weighting, no outcome differed. - The raw figures measured who takes these drugs, not what the drugs did. - With 233 exposed patients, the adjusted nulls are weak reassurance rather than proof of safety. A near-fourfold rise in infections is the kind of number that travels. This one did not survive its own paper, and watching it die is more useful than any of the results. ## The raw pass Adults with type 2 diabetes undergoing rotator cuff repair between 2018 and 2024 were pulled from a research network and split by whether they filled a GLP-1 before surgery. [\[1\]](https://thisglp.com/research/glp1-shoulder-surgery-adjustment#ref-1) Compared directly, the users looked worse on three of the ninety-day outcomes. Respiratory complications came in at an odds ratio of 1.97, 95% CI 1.32 to 2.86, p = 0.0006. Urinary tract infection at 3.85, 95% CI 1.31 to 9.12, p = 0.0055. Postoperative stiffness at 2.20, 95% CI 1.31 to 3.49, p = 0.0016. Three significant results pointing the same way — which is what [an unmatched comparison](https://thisglp.com/research/do-glp1-drugs-cause-gout) usually looks like. ## The adjusted pass The authors then reweighted the sample so the two groups resembled each other on measured characteristics. Every difference vanished. Nothing about the patients changed. Only the question did. The first pass asked whether GLP-1 users have more complications. The second asked whether taking one causes them. Those are [two answers from one dataset](https://thisglp.com/research/do-glp1-drugs-improve-blood-vessel-function). What the raw numbers were measuring People with type 2 diabetes who are prescribed a GLP-1 tend to be heavier, further along, and carrying more other conditions than people with diabetes who are not. Line them up against each other untouched and you are comparing two different patient populations. The odds ratios were real. They were describing who gets the prescription. ## Do not flip it into reassurance Only 233 patients were exposed. That is a thin base for detecting a complication that happens to a small percentage of people. So the honest reading is that this study found nothing, not that there is nothing to find. The authors say prospective work is needed, and they are right, because [finding no difference is not the same as showing none exists](https://thisglp.com/research/does-a-glp1-affect-surgery-outcomes). ## What it is good for A reader will meet the raw version of a number like this before the adjusted one. Social posts carry the 3.85. Papers carry the null. The question to ask of any alarming figure about these drugs is whether the comparison group was built or just found. Most of what gets circulated about real-world GLP-1 use is the found kind, which is [the whole difficulty with evidence collected outside a trial](https://thisglp.com/research/glp1-weight-loss-in-ordinary-care). ## Frequently asked Do GLP-1 drugs raise complication risk after shoulder surgery? Not in this study once the comparison was adjusted. The raw figures showed more respiratory complications, urinary infections and stiffness, and none of it held up after propensity weighting. Why did the numbers change so much? Because people prescribed a GLP-1 for type 2 diabetes differ from those who are not. The unadjusted comparison was measuring who receives the prescription. Does this prove the drugs are safe before surgery? No. Only 233 of 5,876 patients were exposed, which is too few to rule out an uncommon complication. The authors call for prospective studies. Is this about anesthesia risk? No. This study counted complications over 90 days after surgery. Concerns about delayed stomach emptying during sedation are a separate question with its own evidence. ## Sources 1. \[1\] Choudhury A, et al. (2026). The impact of glucagon-like peptide-1 (GLP-1) receptor agonists on postoperative outcomes following rotator cuff repair Shoulder & Elbow. [PMID 42712738](https://pubmed.ncbi.nlm.nih.gov/42712738/) ## Where to get it ### Best GLP-1 injections Every injectable seller we can verify, with the price each one publishes and an honest read of what the trials measured. 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