Colonoscopy and Flexible Sigmoidoscopy advice for Diabetics
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1 Colonoscopy and Flexible Sigmoidoscopy adice for Diabetics Information for patients Guidelines for Diet and Tablet controlled diabetes: pages 2-4 Guidelines for Insulin controlled diabetes: pages 5-8
2 Diet and Tablet controlled diabetes (Including Liraglutide (Victoza), Exenatide (Byetta) Injections) You will need to follow a special low fibre diet for 2 days before your procedure. This may affect your blood sugar leels. This information will help you prepare for your procedure. TWO DAYS BEFORE your procedure: Continue to take your usual Diabetic tablets When following the low fibre diet make sure you eat your usual amount of carbohydrates such as white bread, white rice, pasta. Choose from the list of foods and fluids allowed at the back of NHS Lanarkshire Colonoscopy booklet (See Section: Important Information Low Fibre diet.) Meal Suggestions Breakfast 1-2 boiled eggs, one medium slice of white bread/toast with scraping of margarine, no jam Lunch White bread, small banana, margarine Eening Meal Chicken (skin remoed)/fish, pork, ham,lean beef, mashed potatoes, gray Supper White toast, scraping of butter/margarine. 2 Colonoscopy adice for diabetics (tablets)
3 ONE DAY BEFORE your procedure: On the day before your appointment, hae breakfast and then take clear fluids only for the rest of the day You may drink water, sugar free squash, clear soup, tea a without milk, black coffee, Boril. See list at back of NHS Lanarkshire Colonoscopy booklet. Instruction on Tablets Continue as normal if you use: Rosiglitazone (Aandia) Pioglitazone (Actos) Sitagliptin /Vildagliptin Morning Gliclazide (Diamicron), Glimeprimide or Diamicron MR talk half your am dose. Metformin/Glucophage SR take your morning dose only. Afternoon/Eening Competact/Aandamet, do not take your pm dose Gliclazide (Diamicron)/Glibenclamide, do not take your eening dose. Injections Liraglutide (Victoza), continue as normal. Exenatide (Byetta), do not take your pm dose. Colonoscopy adice for diabetics (tablets) 3
4 Morning of procedure Do not hae anything to eat or drink Do not take any diabetic medication If you hae a blood glucose meter, check your blood sugar. If your blood sugar is less than 4mmols, hae small glass of a sugar containing drink, such as lucozade, lemonade. If you do not hae a blood glucose meter, your blood sugar will be checked when you arrie for the procedure. Bring your tablets with you to hospital to hae after the procedure. After the procedure, resume your normal pattern of food when adised by nursing staff. If you hae any queries regarding your diabetes medication, please contact your diabetes team for adice Wishaw General Hospital Monklands Hospital Hairmyres Hospital Colonoscopy adice for diabetics (tablets)
5 Guidelines for patients on insulin You will need to follow a special low fibre diet for 2 days before your procedure. This may affect your blood sugar leels. This information will help you prepare for your procedure. TWO DAYS PRIOR to colonoscopy Take your usual insulin. Ensure you eat your usual amount of carbohydrates, such as white bread, pasta, rice. Choose from the list of allowed foods and fluids at the back of NHS Lanarkshire Colonoscopy booklet. See Section Important information Low fibre Diet. Meal suggestions Same as for tablet and diet controlled (see page 2) DAY BEFORE Colonoscopy Continue to take your insulin but the amount you take will need to be reduced. Follow the instructions on page 6, Guidelines on Insulin Adjustment. Monitor blood at least 4 times daily. Hae breakfast in the morning. (See list of foods allowed in the NHS Lanarkshire Colonoscopy booklet) then take clear fluids only. You may drink water, sugar free squash, clear soup, tea without milk, black coffee. These do not hae carbohydrate. To include some carbohydrate in your diet, you will need to drink some fluids with sugar in place of your regular meals. Colonoscopy adice for diabetics (insulin) 5
6 The following contain a similar amount of carbohydrate to a medium size slice of bread: 1 glass of unsweetened apple juice ½ glass of ordinary squash Small can of ordinary lemonade/cola ½ glass lucozade Hypo treatment If blood leels fall below 4mmols, the following are suitable treatments: ½ glass of Lucozade Small can of lemonade/cola 3tsp of sugar in clear fluid 3 glucose tablets 6 Colonoscopy adice for diabetics (insulin)
7 Guidelines on insulin adjustment If you are on insulin 2, 3 or 4 times a day you should contact your Diabetes Specialist Team for adice. Wishaw General Hospital Monklands Hospital Hairmyres Hospital Instructions if you use once daily insulin: Lantus, Leemir, Insulatard, Humulin I in addition to tablets. DAY BEFORE Procedure Reduce your insulin by half Monitor bms 2 hourly Continue as normal if you use: Pioglitazone Take half your usual dose if you use: Diamicron MR once daily Glimeprimide (Amaryl), Afternoon/Eening Metformin/Glucophage SR do not take your pm dose Gliclazide/glibenclamide do not take your pm dose Competact/Aandamet, do not take your pm dose Colonoscopy adice for diabetics (insulin) 7
8 Day of Procedure Do not take your insulin. Bring your insulin with you to hospital to hae after the procedure. After the procedure, resume your normal pattern of food when adised by nursing staff. If once daily insulin is taken in the morning, you should take your normal dose after your procedure. If once daily dose is taken in the eening you should take it at your usual prescribed time. If you hae any queries regarding your diabetes medication, please contact your diabetes team for adice Wishaw General Hospital Monklands Hospital Hairmyres Hospital Hairmyres Hospital East Kilbride G75 8RG Monklands Hospital Monkscourt Aenue Airdrie ML6 0JS Wishaw General Hospital 50 Netherton Street Wishaw ML2 0DP Pub. date: August 2010 Reiew date: August 2012 Issue No: 01 Department: Diabetes Team PIL.COLDBT L Design - Medical Illustration, NHS Lanarkshire
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