This document provides guidelines for preparation prior to, during and following investigative procedures. Individual patients and individual circumstances may vary.

SBAR Preparation Prior to Procedure
Situation Preparation prior to an investigative procedure will undoubtedly affect normal routine and lifestyle. Alteration of eating pattern and/or lifestyle can adversely affect the management of diabetes
Background Establish type of diabetes and usual diabetes treatment. Hospital admission prior to procedure may reduce risk of complications in complex/frail/elderly patients
Assessment Consider relevant aspects of patient history/preparation which will influence management e.g.
  • Ability to self manage
  • Age and stage in life
  • Bowel preparation prior to procedure, anti coagulation management
  • Diabetes medication
  • Fasting requirement
  • Cardiovascular complications
  • Renal function
  • Recent glycaemic control (home monitoring/HbA1c)
Recommendation
  • Consider hospital admission for frail/elderly and/or identified ‘at risk’ patients
  • Manage and alter medication proactively if necessary to prevent problems with hypo/hyperglycaemia before, during and following procedure
  • Monitor blood glucose levels appropriately to assess glycaemic control peri procedure
  • Ensure appropriate treatment for hypoglycaemia is available
  • Ensure prevention and management of hypoglycaemia is discussed with patients (and carers) prior to procedure
  • Avoid insulin omission thereby reducing risk of diabetic ketoacidosis
  • Follow guidelines to reduce risk of lactic acidosis in patients prescribed Metformin
  • Refer to Diabetes Team if necessary:
    • Diabetes Specialist Nurses (Office hours Monday – Friday)
    • Ninewells Hospital - 01382 660111 ext. 32293/36009
    • Perth Royal Infirmary - 01382 660111 ext. 13476
    • Abbey Health Centre, Arbroath - 01241 430303
    • Diabetes Specialist Registrar - Page 5416