{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:43:56Z","timestamp":1792601036701,"version":"4.5.0"},"reference-count":35,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ARM"],"abstract":"<jats:p>Introduction: Diabetic gastroparesis increases the risk of aspiration, pneumonia, and sepsis, yet the impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on these outcomes is uncertain because of their gastric-emptying effects. Methods: We performed a retrospective cohort study using the TriNetX Global Research Network. Adults (\u226518 years) with diabetes mellitus and gastroparesis were identified and divided into two cohorts based on GLP-1 RA exposure. Propensity score matching (1:1) balanced demographics, comorbidities, and antidiabetic medications, yielding 23,371 patients per cohort. Outcomes, assessed from 180 days after index, included pneumonia, pneumonitis, mechanical ventilation, ventilator-associated pneumonia, sepsis, bacteremia, empyema, lung abscess, acute respiratory distress syndrome (ARDS), and need for enteral feeding. Risk ratios (RRs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated. Results: Compared with GLP-1 users, non-GLP-1 patients had higher incidences of pneumonitis (3.6% vs. 2.5%; HR 1.76, 95% CI 1.58\u20131.95), pneumonia (13.2% vs. 12.2%; HR 1.34, 95% CI 1.27\u20131.41), mechanical ventilation (4.4% vs. 3.3%; HR 1.63, 95% CI 1.49\u20131.79), sepsis (12.8% vs. 11.1%; HR 1.44, 95% CI 1.37\u20131.52), and bacteremia (5.2% vs. 4.4%; HR 1.46, 95% CI 1.35\u20131.59) (all p &lt; 0.001). Empyema and ARDS were also numerically lower among GLP-1 users, while ventilator-associated pneumonia and lung abscess were rare and similar between groups. No patients required percutaneous endoscopic gastrostomy or nasal enteral feeding. Conclusions: In patients with diabetes and gastroparesis, GLP-1 RA therapy was associated with significantly fewer pulmonary and systemic infectious complications. These data suggest that the systemic benefits of GLP-1 RAs may outweigh concerns regarding delayed gastric emptying in this high-risk population.<\/jats:p>","DOI":"10.3390\/arm94020020","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T09:11:14Z","timestamp":1774429874000},"page":"20","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Glucagon-like Peptide-1 Receptor Agonist Therapy and Risk of Pulmonary and Systemic Infections in Diabetic Gastroparesis: A Propensity-Matched Cohort Study"],"prefix":"10.3390","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9401-9119","authenticated-orcid":false,"given":"Muhammad Ali Ibrahim","family":"Kazi","sequence":"first","affiliation":[{"name":"Luminis Health Anne Arundel Medical Center, Annapolis, MD 21401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7747-8374","authenticated-orcid":false,"given":"Hasan","family":"Kamal","sequence":"additional","affiliation":[{"name":"Luminis Health Anne Arundel Medical Center, Annapolis, MD 21401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6724-5393","authenticated-orcid":false,"given":"Syed Musa","family":"Mufarrih","sequence":"additional","affiliation":[{"name":"Medical College, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imran","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanmeet","family":"Singh","sequence":"additional","affiliation":[{"name":"Luminis Health Anne Arundel Medical Center, Annapolis, MD 21401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrien","family":"Mazer","sequence":"additional","affiliation":[{"name":"Luminis Health Anne Arundel Medical Center, Annapolis, MD 21401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"107733","DOI":"10.1016\/j.jdiacomp.2020.107733","article-title":"Diabetic gastroparesis: An overview of pathogenesis, clinical presentation and novel therapies, with a focus on ghrelin receptor agonists","volume":"35","author":"Petri","year":"2021","journal-title":"J. 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