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If fasting guidelines are instead meant to minimize aspiration events without respect to residual gastric contents, then I think we need to start questioning what amount of residual gastric contents (and what type) are clinically significant.2 Oprea and colleagues published a correspondence this month addressing some of the criticisms of their article

Following failure of initial treatment with metformin and comprehensive lifestyle interventions, the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) consensus report and ADA Standards of Care for Diabetes recommend GLP1RAs for use throughout the treatment pathway for T2D, in particular if there is concern about hypoglycaemia or weight gain

Limitations and potential biases of the review Although this review provides a comprehensive synthesis of current evidence on GLP-1 RAs as potential gerotherapeutics, several limitations warrant consideration

Timely initiation of iron replacement, epoetin and phosphatebinding treatments are important considerations