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Patient Information

Diabetes and having an endoscopy without bowel preparation

https://kingstonhospital.nhs.uk/information/diabetes-and-having-an-endoscopy-without-bowel-preparation

This leaflet is for anyone with diabetes (of any type) who is due to have an endoscopy.

This covers:

  • gastroscopy
  • transnasal gastroscopy
  • sigmoidoscopy without bowel preparation
  • ERCP.
Bowel preparation (or ‘Bowel prep’) means completely emptying the lower bowel before a procedure.

This is not needed for procedures that only involve inspection via the mouth or nose.

Here we cover how to alter your insulin or other diabetes medication around the time of your appointment to control your blood sugar safely.

Follow what applies to you:

Instructions for those on insulin

Instructions for those on medications other than insulin

If you control your diabetes with diet alone, you do not need to do anything apart from following the general guidance you have been sent.

Remember:

Tell the endoscopy team that you have diabetes. We can then give you an appointment as close to the start of the morning or afternoon as possible. This is to reduce any disruption to your usual insulin or medication regimen.

On the day before and the day of the procedure carry glucose tablets in case of low blood sugar levels. If your blood sugar level drops (less than 4 mmol/l), see the hypoglycaemia instructions at the end of this document.

If you have had a ‘hypo’ and taken glucose, tell the nurses when you arrive.

If you usually check your blood sugar levels yourself, you should continue to do so, particularly before taking insulin. If you do not usually check them, we will do so when you arrive.

Instructions for those on insulin

What insulin are you on?

Insulin twice a day (before breakfast and before evening meal)

Novomix 30
Humalog Mix25 or Mix50
Humulin M3

Short-acting insulin before meals (3 times a day)

Novorapid
Humalog
Apidra

Background insulin in the morning and/or evening

Insulatard
Humulin I

Background insulin in the morning and/or evening

Levemir (detemir)
Lantus (glargine) Toujeo
Tresiba

Day before

No change

No change

If you have your insulin in the morning, no change.

If you have your insulin in the evening, reduce the dose by 20%.

To work out your reduced dose, times your usual dose by 0.8 .

No change

Day of appointment

Take half your usual morning insulin dose with a light breakfast 6 hours before appointment.

Take your usual insulin dose in the evening.

Morning appointment (before 12.30):
Do not take your morning insulin.
Start taking your usual doses when you start eating and drinking again.

Afternoon appointment (after 12.30):
Take your usual morning insulin but not your lunchtime dose.
Start taking your usual doses again with evening meal.

If you have your insulin in the morning, reduce the dose by 20%.

To work out your reduced dose, times your usual dose by 0.8 .

If you have your insulin in the evening, no change.

No change

Instructions for those on medications other than insulin

What diabetes medication are you on?

Tablets

metformin
sitagliptin
saxagliptin
linagliptin
repaglinide
pioglitazone
dapagliflozin
empagliflozin
acarbose

Tablets

gliclazide
glimepiride
tolbutamide
glibenclamide

Tablets

exenatide
liraglutide (Saxenda, Victoza)
dulaglutide (Trulicity)
Bydureon
semaglutide (Ozempic)
Xultophy
lixisenatide

Morning appointment (before 12.30):

• Do not take your morning dose.
• If you are able to eat lunch, take your usual lunchtime dose PLUS half your breakfast dose at the same time.

Afternoon appointment (after 12.30):

• Take your morning dose with breakfast.
• Do not take your lunchtime dose.
• Start taking your medication as normal when you start eating and drinking as usual.

Morning appointment (before 12.30):

• Do not take your morning dose.
• If you are able to eat lunch, take your usual lunchtime dose PLUS half your breakfast dose at the same time.

Afternoon appointment (after 12.30):

• Do not take morning OR lunchtime doses.
• Start taking your medication as normal when you start eating and drinking as usual.

Morning appointment (before 12.30):

Take your dose as normal.







Afternoon appointment (after 12.30):

Take your dose as normal.

General advice

For advice about insulin dose adjustments, contact the diabetes nurse team on 020 8934 6370.

Avoiding low blood sugars

  • Check your blood glucose regularly.
    If it drops below 4 mmol/l, have approximately 20g carbohydrate (see Box 1 ) until your blood glucose is back above 5. You can do this for up to 4 hours before your appointment.
  • To avoid the risk of low blood sugars, you can have sips of water and/or sips containing carbohydrates until 2 hours before your appointment. 
    See Box 1 for examples.
Box 1
For approx. 20g carbohydrates

 200ml (13 tablespoons) of non-diet cola 
OR
  4 teaspoons of sugar in 100ml of water
OR
 200ml clear apple/grape juice
OR
 220ml Lucozade
OR
 5 or 6 glucose tablets

Hypoglycaemia

  • If you have a hypo (hypoglycaemia) during the 4 hours before your appointment, follow the advice in Box 2.
    Tell the endoscopy department if this happens.
  • If your blood glucose does drop below 4 and/or you take glucose, let the endoscopy nurses know when you arrive, or call us if you think that it will be difficult to come for your appointment. 
Box 2
Hypo treatment

Step 1
Take 15 to 20g rapid-acting glucose:
5 to 6 dextrose/Lucozade sweets
OR
5 to 6 Glucotabs
OR
150ml to 200ml fruit juice or non-diet cola
OR
one 60ml bottle Glucojuice (Lift)

Step 2
Test glucose after 10 minutes
Repeat step 1 if still below 4.0mmol/L
Diabetes and having an endoscopy without bowel preparation - Kingston Hospital Download PDF


Contacts

Endoscopy nurses helpline 020 8934 6614 (2pm to 4pm only)
Diabetes nurses 020 8934 6370

Translate Please speak to a member of staff before or during your visit to the hospital if you require translation.
Accessibility Please contact the Patient Experience Team on 020 8934 3850 if you need this information in a different format.
For information accessibility please visit Kingston Hospital AccessAble www.accessable.co.uk/kingston-hospital-nhs-foundation-trust
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Visit the hospital website, ask a member of staff, or ring us for details.

www.kingstonhospital.nhs.uk

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Accessibility

Please contact the Patient Experience Team on 020 893 3850 if you need this information in a different format.
For detailed information on accessibility at Kingston Hospital visit Kingston Hospital AccessAble (https://www.accessable.co.uk/kingston-hospital-nhs-foundation-trust).


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