Tayside Diabetes MCN Handbook - Preparation Prior to Procedures for People with Diabetes

General information

Nil by mouth from 22.00hours on evening prior to procedure
Early morning appointment desirable (9.00 hrs)
Oral hypoglycaemic agents and/or insulin can cause hypoglycaemia
Ensure blood glucose monitoring is undertaken and appropriate treatments for hypoglycaemia are available

Continue basal (long acting) insulin as prescribed in people with type 1 diabetes. Basal insulin preparations include Lantus, Levemir, Insulatard, & Humulin I
Omit breakfast insulin prior to procedure (except basal insulin)
Resume usual insulin as prescribed with food after procedure
N.B If 9.00 am appointment cannot be arranged, consider using G.K.I.
If BD insulin regimen is restarted at lunchtime it is recommended that half of the normal ‘breakfast’ insulin dose should be prescribed with lunch after procedure

No solid food from 08 00 hours on the day prior to procedure
Bowel preparation as per instruction from radiology
The success of the procedure depends on the bowel being as clear as possible
Picolax instructions recommend a low residue diet with water/clear fluids 250mL hourly throughout the treatment with picolax until bowel movements have ceased
It is essential that people prescribed oral hypoglycaemic agents and insulin have regular carbohydrate intake.
The following fluids contain 10 grams CHO: 100mL fruit juice, 50mL lucozade, 150mL coca cola/lemonade (not diet) and 2 tablespoons jelly (ordinary).
NB no fizzy drinks allowed, therefore allow lucozade, cola and lemonade to ‘go flat’ prior to consumption
Oral hypoglycaemic agents and/or insulin can cause hypoglycaemia
Ensure blood glucose monitoring is undertaken and appropriate treatments for hypoglycaemia are available
Early morning appointment desirable

Sulphonylureas (e.g. Gliclazide, Glipizide, Glimepiride) dose may require (50%) reduction during bowel preparation to reduce risk of hypoglycaemia
Omit diabetes medication on morning of procedure
Resume usual diabetes medication with food after procedure.

May require reduction (30 - 50%) in insulin doses during the day prior to procedure during bowel preparation to prevent hypoglycaemia
Continue basal (long acting) insulin as prescribed in people with type 1 diabetes. Basal insulin preparations include Lantus, Levemir, Insulatard & Humulin I
Omit breakfast insulin on morning of procedure (except basal insulin)
Consider using G.K.I. infusion prior to and during procedure
Resume usual insulin as prescribed with food after procedure
If BD insulin regimen is restarted at lunchtime it is recommended that half of the normal ‘breakfast’ insulin dose should be prescribed with lunch after procedure

Early morning appointment desirable
Food and fluid fast from 22.00 hours on evening prior to procedure
Oral hypoglycaemic agents and/or insulin can cause hypoglycaemia
Ensure blood glucose monitoring is undertaken and appropriate treatments for hypoglycaemia are available

Continue basal (long acting) insulin as prescribed in people with type 1 diabetes. Basal insulin preparations include Lantus, Levemir, Insulatard & Humulin I
Omit breakfast insulin on morning of procedure
Resume usual insulin with food after procedure
If BD insulin regimen is restarted at lunchtime it is recommended that half of the normal ‘breakfast’ insulin dose should be prescribed with lunch after procedure