Guidelines for people with diabetes undergoing upper GI endoscopy (gastroscopy)

/Guidelines for people with diabetes undergoing upper GI endoscopy (gastroscopy)
Guidelines for people with diabetes undergoing upper GI endoscopy (gastroscopy)2019-01-08T19:40:48+00:00

If you have any questions or concerns contact the Endoscopy Department or contact your Diabetes Carer (if under the care of GP).

Adjusting therapy

As a patient with diabetes you will need to adjust your treatment according to the timing of your appointment.  As a result your blood sugar may be a little higher than usual.  This is only temporary to maintain your blood glucose through the procedure and you will be back to your usual level of control within 24-48 hours of the procedure.

Carrying glucose to treat hypoglycaemia

Whilst fasting carry glucose tablets (e.g. Lucozade tablets or Glucotabs) in case of hypoglycaemia.  As these are absorbed quickly through the tissues in the mouth, if sucked, they will not interfere with the procedure.  Take three (3) tablets initially, followed by a further three (3) if symptoms continue after 5 minutes.  If your medication has been adjusted this should not be a problem.

Blood glucose monitoring

If you usually test your blood glucose levels, check them as usual, on the morning of the procedure and carry your equipment with you to the appointment.

Dose adjustment advice

If you have concerns about adjusting your dosage, please contact your own diabetes liaison nurse or the endoscopy unit, well in advance of the appointment to discuss further.

Morning Appointment
Patients taking oral anti-diabetic medication

Diabetes Treatment Diet Tablets
Day before investigation Eat and drink as normal Take as normal
Supper time EAT A SUBSTANTIAL SNACK THEN NOTHING TO EAT FOR 6 HOURS BEFORE YOUR ENDOSCOPY
Morning of investigation Nothing to eat or drink Do not take tablets
Afterwards Eat and drink when advised Resume tablets with first meal

Patients taking insulin

Diabetes Treatment Once a day Insulin Twice daily Insulin Insulin four times a day
Day before investigation If taken in the morning take as normal Morning dose take as normal Take pre-meal  insulin as normal
If taken in evening take ½ normal dose Evening dose take ½ normal dose Evening dose (long acting) take ½ normal dose
Supper time EAT A SUBSTANTIAL SNACK THEN NOTHING TO EAT FOR 6 HOURS BEFORE YOUR ENDOSCOPY
Morning of investigation No insulin No insulin No insulin
Afterwards If you take insulin in the morning eat and drink when advised and take 2/3 normal dose of insulin Take ½ normal morning dose of insulin with first meal Take usual dose of fast acting insulin with midday meal

Afternoon Appointment
Patients taking oral anti-diabetic medication

Diabetes Treatment Diet Tablets
Day before investigation Eat and drink as normal Take as normal
Morning of investigation Light breakfast then nothing to eat Take Metformin, Rosiglitazone or Pioglitazone normally
Omit gliclazide, glibenclamide, tolbutamide, glimeperide, glipizide, nateglinide repaglinide, sitagliptin, linagliptin, saxagliptin, vildagliptin, exanatide, liraglutide, canaglifozin, dapaglifozin and empagliflozin.
Afterwards Eat and drink when advised Resume tablets with first meal

Afternoon Appointment
Patients taking insulin

Diabetes Treatment Once a day Insulin Twice daily Insulin Insulin four times a day
Day before investigation If taken in the morning take as normal Morning dose take as normal Take pre-meal insulin as normal
If taken in evening take ½ normal dose Evening dose take as normal Evening dose (long acting) take 2/3 normal dose
Morning of investigation If insulin taken in the morning take ½ usual dose Take ½ of morning dose of insulin Take ½ of morning dose of insulin

No insulin at lunchtime

Afterwards If you take evening insulin – take insulin as normal Evening dose take as normal Take usual dose of fast acting insulin with evening meal and usual dose of long acting insulin