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

General information

Four hour food fast
Water allowed until two hours prior to procedure
Assessment of swallow following procedure before resuming food
If swallow reflex has not returned in two hours post procedure G.K.I 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

Take prescribed diabetes medication with food prior to fast
Check swallow and resume diabetes medication as prescribed with food following procedure

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
Check swallow and resume normal insulin with food following 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

Four hour food fast,
Water allowed until two hours 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

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

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

Discontinue Metformin (if normally prescribed) 48 hours before procedure - Radiological Procedures with Iodine Containing Contrast
Continue any other tablets for diabetes except Metformin
Follow guidelines on restarting Metformin

Discontinue Metformin 48 hours before procedure - see Radiological Procedures with Iodine Containing Contrast
Continue usual insulin regimen
Follow guidelines on restarting Metformin