Antihyperglycemic therapy during colonoscopy preparation: A review and suggestions for practical recommendations

Abstract

Patients with diabetes have distinct risks during precolonoscopy bowel preparation, caused by change of diet, change of antihyperglycemic medication regimens and diabetes-related complications and comorbidities. These risks include hypoglycemia, water and electrolyte imbalance, acute renal failure, lactic acidosis, ketoacidosis and low quality of bowel preparation. Here we review the existing literature and present recommendations from a subcommittee of the Israeli National Diabetes Council for primary care physicians and gastroenterologists. The instructions include general suggestions on diet and glucose monitoring and specific recommendations on timing of modification or cessation of each of the antihyperglycemic medication types to ensure patient safety during bowel preparation.

Periprocedural Euglycemic Diabetic Ketoacidosis Associated With Sodium–Glucose Cotransporter 2 Inhibitor Therapy During Colonoscopy

“…More than 10% of adults undergoing colonoscopy have type 2 diabetes (T2D) ( 1 ). The use of sodium–glucose cotransporter 2 inhibitors (SGLT2i) has increased due to their glycemic control and benefits of lowering cardiovascular morbidity and mortality as well as reducing diabetic nephropathy ( 2 , 3 ).…”

Bowel preparation in diabetic patients undergoing colonoscopy

“…Diabetic patients are usually advised to schedule their surgeries in the early morning to avoid prolonged fasting and subsequent hypoglycemia or hyperglycemia [ 33 - 35 ]. However, there is no strong evidence to support this early scheduling [ 36 ]. In addition, the American Society of Anesthesiologists allows the intake of clear liquid diet up to a minimum of 2 h prior to a scheduled procedure under sedation or general anesthesia [ 37 ].…”

Eğitim Seviyesinin Kolonoskopi Temizlik Başarısındaki Rolu: Retrospektif Değerlendirme

“…Yetersiz kolonoskopi hazırlığının nedenlerinden biri de hastaların işlem ve ilaç kullanımı için yetersiz bilgilendirilmesidir. Kişinin hastanede yatan hasta olması, bazı ilaçlar, immobil nörolojik veya ortopedik hastalığın olması, yaşlılık, kabızlık öyküsü olması, siroz ve erkek cinsiyet çeşitli çalışmalarda yetersiz barsak temizliği ile ilişkilendirilmiştir (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13) (22). Çalışma öncesi öngörümüz eğitim seviyesinin yüksekliğinin barsak temizliğinin kalitesinin artışı ile paralel olacağı lehineydi.…”