Your blood sugar will be checked on arrival to Endoscopy and monitored whilst you are there.

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1 GASTROSCOPY TABLET CONTROLLED DIABETES (Including injectable medication which is not insulin) MORNING APOINTMENT Take your tablets as normal on the day before the test. On the day of the test: Omit your morning tablets HAVE NOTHING TO EAT OR DRINK. Your blood sugar will be checked on arrival to Endoscopy and monitored whilst you are there. Bring a sandwich with you for after the procedure and take your normal lunchtime tablets with the food. Once home you should resume your usual tablet regime.

2 GASTROSCOPY TABLET CONTROLLED DIABETES (Including injectable medication which is not insulin) AFTERNOON APOINTMENT Take your tablets as normal on the day before the test. On the day of the test: Omit your morning tablets FOLLOWING A LIGHT BREAKFAST BEFORE 8AM, HAVE NOTHING MORE TO EAT OR DRINK. Your blood sugar will be checked on arrival to Endoscopy and monitored whilst you are there. Once home you should resume your usual tablet regime.

3 GASTROSCOPY INSULIN TREATED DIABETES MORNING APPOINTMENT If you inject yourself 4 times a day with insulin, take half your usual bedtime (basal) dose. Otherwise take your insulin doses as usual Take any diabetes tablets as usual. Do not take your insulin or tablets in the morning. HAVE NOTHING TO EAT OR DRINK Check your blood sugar when you get up, it will be monitored whilst you are in the endoscopy department. You should bring a sandwich and your insulin to have following the procedure. If you inject normally at lunchtime have your usual dose with food. If you usually only inject twice a day, take half your usual breakfast dose with food. When you return home resume your usual insulin and tablet regime.

4 GASTROSCOPY INSULIN TREATED DIABETES AFTERNOON APPOINTMENT If you usually inject at breakfast time, inject half your usual dose with a light breakfast before 8am. Omit any diabetes tablets on the morning of the test. FOLLOWING A LIGHT BREAKFAST YOU SHOULD HAVE NOTHING MORE TO EAT OR DRINK. Check your blood sugar during the morning; it will be monitored whilst you are in the endoscopy department. When you return home resume your usual insulin and tablet regime.

5 COLONOSCOPY TABLET CONTROLLED DIABETES (Including injectable medication which is not insulin) MORNING APOINTMENT Following breakfast, have nothing more to eat. Do not take your diabetes tablets or injections today. Monitor your blood sugar, if it is below 5mmol/l drink sugary fluids such as Lucozade or lemonade (non diet).in addition drink plenty of sugar free fluids. Do not take your diabetes tablets or injection. Do not eat anything until after the procedure. Continue to drink plenty of fluids. Monitor your blood sugar, if it is below 5mmol/l drink sugary fluids such as Lucozade or lemonade (non diet). Bring a sandwich with you for after the procedure and take your normal lunchtime tablets with the food. When you return home resume your usual medication regime.

6 COLONOSCOPY TABLET CONTROLLED DIABETES (Including injectable medication which is not insulin) AFTERNOON APOINTMENT Following lunch, have nothing more to eat. Take your normal diabetes tablets or injections at breakfast time. Monitor your blood sugar, if it is below 5mmol/l drink sugary fluids such as Lucozade or lemonade (non diet).in addition drink plenty of sugar free fluids. Do not take your diabetes tablets or injection. Do not eat anything until after the procedure. Continue to drink plenty of fluids. Monitor your blood sugar, if it is below 5mmol/l drink sugary fluids such as Lucozade or lemonade (non diet). Bring a sandwich with you for after the procedure and take your normal evening diabetes tablets with the food. The next day resume your usual medication regime including any injections.

7 COLONOSCOPY INSULIN TREATED DIABETES MORNING APPOINTMENT Following breakfast, have nothing more to eat. Half your insulin dose at breakfast time Half your insulin dose at lunchtime (if normally taken with lunch) and half your evening mealtime dose. Take your normal dose of bedtime insulin (basal insulin) Keep a close check on your blood sugar levels. If your blood sugar is greater than 9mmol/l, drink sugar free fluids If your blood sugar is between 5 and 9mmol/l, alternate between sugar free and sugary fluids If your blood glucose is less than 5 mmol/l, drink sugary fluids to avoid hypoglycaemia. Omit your morning insulin Do not eat anything until after the procedure. Continue to keep a close check on your blood sugar and treat as above. This will be monitored for you in the Endoscopy department. Bring a sandwich with you for after the test. Take usual lunchtime dose or half your usual breakfast dose if you do not take insulin at lunchtime normally. Then resume your usual insulin regime. The Diabetes Specialist Nurse will contact you for more specific advice about managing your diabetes and insulin prior to the procedure.

8 COLONOSCOPY INSULIN TREATED DIABETES AFTERNOON APPOINTMENT Following lunch, have nothing more to eat. Half your insulin dose at breakfast time Half your insulin dose at lunchtime (if normally taken with lunch) and half your evening mealtime dose. (If normally taken at that time) Take your normal dose of bedtime insulin (basal insulin) if used. Keep a close check on your blood sugar levels. If your blood sugar is greater than 9mmol/l, drink sugar free fluids If your blood sugar is between 5 and 9mmol/l, alternate between sugar free and sugary fluids If your blood glucose is less than 5 mmol/l, drink sugary fluids to avoid hypoglycaemia. Take half your usual morning insulin. Do not take any lunchtime insulin if usually take at this time. Do not eat anything until after the procedure. Continue to keep a close check on your blood sugar and treat as above. This will be monitored for you in the Endoscopy department. Bring a sandwich with you for after the test. Take usual evening dose of insulin and any diabetes tablets that you normally take at this time. Take any bedtime (basal) insulin as usual. The next day resume your usual insulin regime. The Diabetes Specialist Nurse will contact you for more specific advice about managing your diabetes and insulin prior to the procedure.

9 GASTROSCOPY and COLONOSCOPY TABLET CONTROLLED DIABETES (Including injectable medication which is not insulin) MORNING APOINTMENT Following breakfast, have nothing more to eat. Drink plenty of fluids. Do not take your diabetes tablets or injections today. Keep a close check on your blood sugar levels. If your blood sugar is greater than 9mmol/l, drink sugar free fluids If your blood sugar is between 5 and 9mmol/l, alternate between sugar free and sugary fluids If your blood glucose is less than 5 mmol/l, drink sugary fluids to avoid hypoglycaemia. Do not take your diabetes tablets or injection. Do not eat anything until after the procedure. Stop drinking four hours prior to the procedure. Bring a sandwich with you for after the procedure and take your normal lunchtime tablets with the food. When you return home resume your usual medication regime.

10 GASTROSCOPY and COLONOSCOPY TABLET CONTROLLED DIABETES (Including injectable medication which is not insulin) AFTERNOON APOINTMENT Following lunch, have nothing more to eat. Drink plenty of fluids. Do not take any diabetes injections today. Take your usual morning tablets with breakfast but do not take any more until after the procedure. Keep a close check on your blood sugar levels. If your blood sugar is greater than 9mmol/l, drink sugar free fluids If your blood sugar is between 5 and 9mmol/l, alternate between sugar free and sugary fluids If your blood glucose is less than 5 mmol/l, drink sugary fluids to avoid hypoglycaemia. Do not take your diabetes tablets or injection. Do not eat anything until after the procedure. Stop drinking four hours prior to the procedure. Bring a sandwich with you for after the procedure and take your normal evening tablets with the food. When you return home resume your usual medication regime including any injections.

11 GASTROSCOPY and COLONOSCOPY INSULIN TREATED DIABETES MORNING APPOINTMENT Following breakfast, have nothing more to eat. Half your insulin dose at breakfast time Half your insulin dose at lunchtime (if normally taken with lunch) and half your evening mealtime dose. Take your normal dose of bedtime insulin (basal insulin) Keep a close check on your blood sugar levels. If your blood sugar is greater than 9mmol/l, drink sugar free fluids If your blood sugar is between 5 and 9mmol/l, alternate between sugar free and sugary fluids If your blood glucose is less than 5 mmol/l, drink sugary fluids to avoid hypoglycaemia. Omit your morning insulin Do not eat anything until after the procedure. Stop drinking 4 hours prior to the procedure. Continue to keep a close check on your blood sugar, if concerned please contact the Endoscopy department for advice as you may require a glucose drip. Your blood sugar will be monitored for you in the Endoscopy department. Bring a sandwich with you for after the test. Take usual lunchtime dose or half your usual breakfast dose if you do not take insulin at lunchtime normally. Then resume your usual insulin regime. The Diabetes Specialist Nurse will contact you for more specific advice about managing your diabetes and insulin prior to the procedure.

12 GASTROSCOPY and COLONOSCOPY INSULIN TREATED DIABETES AFTERNOON APPOINTMENT The advice from the Diabetes Specialist Team is to avoid performing this procedure in the afternoon for people who have insulin treated diabetes. If this is unavoidable, then the patient should be admitted the day before the procedure and managed with IV insulin and glucose infusion to control blood glucose levels prior to and during the procedure. For further advice please contact the Diabetes Specialist Nurses on EXTENSION 2893.

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