Endoscopy or colonoscopy guidelines for patients with diabetes

Abstract

AbstractLocal pilot guidelines for patients with diabetes undergoing an endoscopy or colonoscopy as an out‐patient were developed to reduce patient anxiety and the risk of hyperglycaemia and hypoglycaemia prior to and during their procedure. Audit was used as a tool to evaluate the guidelines.The audit highlighted that very few patients treated with insulin are prioritised to have their procedure early on the morning list.The results demonstrated that, of the 12 patients who normally experienced at least one hypoglycaemic episode (blood glucose <4mmol/L) a week, none reported an increase in hypoglycaemia experienced, and five patients had improved control. Of the 28 patients who did not normally experience at least one hypoglycaemic episode a week, all patients continued to be free from hypos. Of the six patients who normally experienced at least one hyperglycaemic episode (≥15mmol/L) a week, none reported an increase in the frequency of their hyperglycaemia, and two patients had improved control. Of the 34 patients who did not normally experience at least one hyperglycaemic episode a week, 32 patients reported no increase in the frequency of hyperglycaemia. However, two patients reported transient asymptomatic hyperglycaemia.The guidelines have assured standardisation of advice now given to patients, and enabled elective patients treated with insulin to be scheduled first on the morning list. Contact with a diabetes specialist nurse has enabled patients to access specialist advice regarding their general diabetes management that they would otherwise have not received. Copyright © 2006 John Wiley & Sons, Ltd.