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Colonoscopy and 24hr fasting......

I

izzy

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Hi! My hubby has to go for a colonoscopy next week. He has been give the prep to mix in with water etc and an instruction sheet. His appointment is early in the morning due to him being diabetic and on insulin. The reason I am posting is because after a light breakfast the day before, he will have nothing to eat until after the procedure the following day. He and I are worried about this especially hypos during the night. The Gastro consultant just said "halve" the amount of each insulin dose which I suppose is logical after his breakfast but to take a further evening dose on an empty stomach ? He has tried contacting the practice nurse ( the surgery has no dedicated diabetic nurse) and she said he will have to go in the night before to be monitored and have a "blood sugar maintenance drip" . I assume she means a dextrose drip. Surely this is not the norm? She said she would try and find out more but as yet not got back to us. Would it be OK to miss out the evening insulin dose? Has anyone else been through something similar, how did you cope?
Any advice would be gratefully received.....thank you.
 
izzy said:
Hi! My hubby has to go for a colonoscopy next week. He has been give the prep to mix in with water etc and an instruction sheet. His appointment is early in the morning due to him being diabetic and on insulin. The reason I am posting is because after a light breakfast the day before, he will have nothing to eat until after the procedure the following day. He and I are worried about this especially hypos during the night. The Gastro consultant just said "halve" the amount of each insulin dose which I suppose is logical after his breakfast but to take a further evening dose on an empty stomach ? He has tried contacting the practice nurse ( the surgery has no dedicated diabetic nurse) and she said he will have to go in the night before to be monitored and have a "blood sugar maintenance drip" . I assume she means a dextrose drip. Surely this is not the norm? She said she would try and find out more but as yet not got back to us. Would it be OK to miss out the evening insulin dose? Has anyone else been through something similar, how did you cope?
Any advice would be gratefully received.....thank you.
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I have had several colonoscopies and like your hubby was admitted the day before as I am diabetic too. He will be allowed lunch and will start drinking litres of Klee-Prep or Picolax to empty his bowels. He will also be monitored for his BGs regularly and put on an Insulin Sliding Scale to taper him down before the procedure. Beware the laxatives are very powerful and liquidize all your stomach and bowel contents rapidly and sometimes you can't even make the toilet. Best tips are be near the toilet bring a roll of toilet paper and lots of underwear if you have an accident lol. The colonoscopy is painless as they shoot you up with very strong painkillers like Fentanyl and sedate you usually with Midazolam. Hope hubby gets sorted.
EDWARD
 
I went for a colonoscopy before and the worst part is the prep but otherwise everything is good because they gave me propofol and slept thru the whole procedure :) different hospitals have different protocols for the colonoscopy prep---better to ask them specifically on your questions :) hope your husband goes well with his colonoscopy, good luck!
 
Which insulins is he taking? If it's mixed then there could be a risk of hypo, if it basal/bolus, then just take the basal (assuming it's set at the correct level).
 
robert72 said:
Which insulins is he taking? If it's mixed then there could be a risk of hypo, if it basal/bolus, then just take the basal (assuming it's set at the correct level).
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They might use Actropid which they will administer IV through a catheter.
 
Adelle0607 said:
I went for a colonoscopy before and the worst part is the prep but otherwise everything is good because they gave me propofol and slept thru the whole procedure :) different hospitals have different protocols for the colonoscopy prep---better to ask them specifically on your questions :) hope your husband goes well with his colonoscopy, good luck!
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Adele sooo correct lol..the prep is the worst, squits arrrggh lol
 
When I got the paperwork for my colonoscopy (18/12) they gave a list of insulin regimes and advised what dose should be taken and when. As 2x per day mix I was advised to halve my dose for the day before and no insulin on the morning of the procedure. I had,a morning appointment, it,will be different if you have an afternoon appointment. Be guided by the experts and don't worry. I haven't eaten since 06:00 this morning and I feel fine, tired but fine.
 
I may have got the gist of the thread right but didn't realise that it was an OP day procedure. In my health area I have always been admitted the day before as an In Patient due to diabetes.
 
I was so trumpy when I had mine. All that air shot up the rear end...
 
eddie1968 said:
I may have got the gist of the thread right but didn't realise that it was an OP day procedure. In my health area I have always been admitted the day before as an In Patient due to diabetes.
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Eddie, we are all so very different with diabetes and of course other health problems that may co-exist. They are happy for me to be investigated as a day case and I can go along with that. My BGs, lipids et al are all fine. If something is not right then it will change. BGs at 4.9 fasting getting up this morning so will be bringing this to attention when I arrive.
 
Adelle0607 said:
I went for a colonoscopy before and the worst part is the prep but otherwise everything is good because they gave me propofol and slept thru the whole procedure :) different hospitals have different protocols for the colonoscopy prep---better to ask them specifically on your questions :) hope your husband goes well with his colonoscopy, good luck!
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Remember Propofol well. Had that stuff for a month in ICU two years ago. It has a nickname as it looks like milk it is called 'Milk of Amnesia' and sends you into a sleep big time. It's the stuff that Michael Jackson had his doctor pump into him and alas killed him as he wasn't monitored at home.
 
Can't help with your insulin requirements, but I too have had several colonoscopies, I opted for medazalam ( sp) it's far less potent than general anaesthesia, it has fantastic amnesia effects but you are compliant . I don't have to use preps, about the only benefit of having a Stoma :-) . With either, you will not remember the procedure. It's a personal choice if you don't mind feeling grotty for a couple of days go for the biggie. In either option the only pain is to your dignity. Leave it at the door and you'll be fine, it's all over very quickly.


Good luck
 
Thanks all for your support and insights....much appreciated! Alanp35 your account is almost the same as what we have now been told by the endoscopy staff today. We decided to visit the unit whilst on a different mission to the hospital. Basically a light non-fibre breakfast the day before and halve the insulin dose, then no food till after the procedure. Monitor the BG's every two hours and drink sugary drinks (lucoszade) and dextrose tabs if required. Miss out the metformin the day before and on the morning of.
The insulin he takes is Novomix 30. which contains slow acting insulin. My concern is whilst its ok on sugar (which is a "fast fix") there nothing for the slower aspect to work on and increases the risk of a hypo whilst asleep. (sorry if this sounds silly or over reactive).
The diabetic procedure paper they gave us this morning, to me leaves much to be desired and your Alanp35 has been more thought about than ours and it didn't include any insulin regimes. I hate to think of a single/lone diabetic person following this procedure. The risk of hypos would be far worst without some there to watch you/them.
My GP practice has no such advice procedure to follow and so the practice nurse has asked that they may copy our copy from the hospital. This is bad in itself. I am going to suggest that this hospital procedure is looked at by the hospitals diabetic clinicians as this is an accident waiting to happen!
 
A good thing to do if worried about hypo during the night, is set an alarm on mobile or clock and get up to do bg test and if need be, eat some glucose tablets.

I wasn't sedated initially and watched on the tv monitor and couldn't believe that I was looking at my insides. I asked for sedation though for the final bit of the procedure and didn't remember anymore until afterwards. The staff and doctors are nice so dont worry.
 
izzy said:
Thanks all for your support and insights....much appreciated! Alanp35 your account is almost the same as what we have now been told by the endoscopy staff today. We decided to visit the unit whilst on a different mission to the hospital. Basically a light non-fibre breakfast the day before and halve the insulin dose, then no food till after the procedure. Monitor the BG's every two hours and drink sugary drinks (lucoszade) and dextrose tabs if required. Miss out the metformin the day before and on the morning of.
The insulin he takes is Novomix 30. which contains slow acting insulin. My concern is whilst its ok on sugar (which is a "fast fix") there nothing for the slower aspect to work on and increases the risk of a hypo whilst asleep. (sorry if this sounds silly or over reactive).
The diabetic procedure paper they gave us this morning, to me leaves much to be desired and your Alanp35 has been more thought about than ours and it didn't include any insulin regimes. I hate to think of a single/lone diabetic person following this procedure. The risk of hypos would be far worst without some there to watch you/them.
My GP practice has no such advice procedure to follow and so the practice nurse has asked that they may copy our copy from the hospital. This is bad in itself. I am going to suggest that this hospital procedure is looked at by the hospitals diabetic clinicians as this is an accident waiting to happen!
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Hi! Sometimes they put patients on a drip to counteract hypos (from what I remember). Case to case basis and monitor bgs in a regular period the night before the procedure and before they go in they do a so-called pre-op checklist. Usually the nurses tick off pertinent details of the stuff that needs checking which includes blood glucose levels (just like in any other surgical procedures too) :)
 
If the blood sugar levels are too low the nurses contact the gastro/anaesthetic doctors then decide if he needs to go on a drip, etc. Usually if they find something alarming, they wouldn't go ahead with the procedure straight away. Post op they would also be checking on these things aside from other concerns. :)
 
I usually get put on a titrated dose of Actropid Insulin through a catheter IV.
 
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