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

General information

Food fast for two hours prior to procedure
Free fluids allowed
Oral hypoglycaemic agents and/or insulin can cause hypoglycaemia
Ensure blood glucose monitoring is undertaken and appropriate treatments for hypoglycaemia are available

Discontinue Metformin 48 hours before procedure – see Radiological Procedures with Iodine Containing Contrast
Take other prescribed diabetes medication with food before fast
Resume diabetes medication (not Metformin) as prescribed with food after procedure.
Follow guidelines on restarting Metformin

If prescribed, discontinue Metformin 48 hours before procedure – see Radiological Procedures with Iodine Containing Contrast
Follow guidelines on restarting Metformin
Continue basal (long acting) insulin as prescribed for people with type 1 diabetes. Basal insulin preparations include Lantus, Levemir, Insulatard & Humulin I
May require reduction (30 – 50%) in insulin prior to fast to prevent hypoglycaemia
Resume normal prescribed 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

Food and fluid fast for 6 hours prior to procedure
2 hours fast post procedure
Assessment of swallow following procedure before resuming food
If swallow reflex has not returned in two hours post procedure GKI infusion should be commenced in people normally treated with tablets and/or insulin
Oral hypoglycaemic agents and/or insulin can cause hypoglycaemia
Ensure blood glucose monitoring is undertaken and appropriate treatments for hypoglycaemia are available

Omit prescribed diabetes medication prior to fast
Assessment of swallow following procedure before resuming food
Check swallow and resume diabetes medication as prescribed with food following fast after procedure

Continue basal (long acting) insulin as prescribed for people with type 1 diabetes. Basal insulin preparations include Lantus, Levemir, Insulatard, & Humulin I
May require reduction (30 – 50%) in insulin dose prior to fast to prevent hypoglycaemia
ALTERNATIVELY, use a G.K.I. infusion prior to and during procedure (anaesthetist preference) – see G.K.I. protocol
Check swallow and resume normal prescribed insulin with food following fast after procedure
Discontinue G.K.I 1 hour after subcutaneous insulin has been administered
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

Six hour food and fluid fast 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

May require reduction (30 – 50%) in insulin dose prior to fast 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
Resume normal insulin with food
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