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

General information

Follow diet and bowel preparation as per instruction from Endoscopy department
On the day before procedure
Light breakfast and lunch on day prior to procedure followed by fluid diet
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
Fluid diet includes black tea or coffee, lemonade, water, strained soup, jelly
Avoid fluids with artificial colours especially red or blackcurrant juices/tomato soup
It is essential that people prescribed oral hypoglycaemic agents and insulin have regular carbohydrate intake
The following fluids contain 10grams CHO: 100mL fruit juice, 50mL lucozade, 150mL coca cola/lemonade (not diet), and 2 tablespoons jelly (ordinary)
Monitor blood glucose and ensure appropriate treatments for hypoglycaemia are available.
9.00 hr appointment desirable on day of procedure

Sulphonylureas (e.g. Gliclazide, Glipizide, Glimepiride) dose may require reduction during bowel preparation to prevent hypoglycaemia
Omit prescribed diabetes medication prior to procedure
Resume diabetes medication as prescribed with food following procedure

Recommend four times daily blood glucose monitoring
May require reduction (30 – 50%) in insulin doses during bowel preparation to prevent hypoglycaemia based on individual assessment and blood glucose monitoring results
Continue basal (long acting) insulin as prescribed in people with type 1 diabetes. Basal insulin preparations include Lantus, Levemir, Insulatard & Humulin I
Omit morning insulin dose prior to procedure
Resume usual prescribed 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

Follow diet and bowel preparation as per instruction from Endoscopy department
On the day prior to procedure
Normal breakfast on day prior to procedure followed by fluid diet
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
Fluid diet includes: black tea or coffee, lemonade, water, strained soup, jelly.
Avoid fluids with artificial colours especially red or blackcurrant juices/tomato soup
It is essential that people prescribed oral hypoglycaemic agents and insulin have regular carbohydrate intake.
The following fluids contain 10grams CHO: 100mL fruit juice, 50mL lucozade, 150mL coca cola/lemonade (not diet), and 2 tablespoons jelly (ordinary)
Monitor blood glucose and ensure appropriate treatments for hypoglycaemia are available
9.00 hr appointment desirable on day of procedure
Six hour food fast prior to procedure
Two hour fluid fast prior to procedure

Sulphonylureas (e.g. Gliclazide, Glipizide, Glimepiride) dose may require reduction during bowel preparation to prevent hypoglycaemia
Omit prescribed diabetes medication prior to fast
Resume diabetes medication as prescribed with food following procedure

Recommend four times daily blood glucose monitoring
May require reduction (30 – 50%) in insulin doses during bowel preparation to prevent hypoglycaemia based on individual assessment and blood glucose monitoring results
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 in insulin dose prior to fast to prevent hypoglycaemia
Resume normal prescribed 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

Six hour food and fast prior to procedure
Two hour fluid fast prior to procedure
Chest x-ray required prior to food/fluid intake
Assessment of swallow following procedure before resuming food
9.00 hr appointment desirable If food and fluid intake is delayed two hours post procedure GKI infusion should be commenced in people normally treated with tablets and/or insulin
Prevent hypoglycaemia in people prescribed oral hypoglycaemic agents and insulin
Monitor blood glucose and ensure appropriate treatments for hypoglycaemia are available

Omit prescribed diabetes prior to fast
Chest x-ray required prior to food/fluid intake
Check swallow and resume diabetes medication as prescribed with food following 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
Chest x-ray required prior to food/fluid intake
Check swallow and resume normal prescribed 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