Lower GI Tablets Controlled

Information for diabetic patients taking ‘tablets’ having Lower Gastrointestinal Endoscopy Procedures

MORNING or AFTERNOON appointment (no later than 2pm)

What to do with your medication for your diabetes, diet and bowel preparation medication

This information aims to help you how to prepare in the days leading up to your endoscopy procedure, either colonoscopy, sigmoidoscopy or enteroscopy.

It will help you understand;

  • What to do with your medication for your diabetes
  • When to take your bowel preparation
  • The required alterations to your diet to make sure your bowel preparation works effectively and to maintain your blood sugar levels

You should;

  • Have received an appointment in the morning or no later than 2pm in the afternoon (if not please contact the endoscopy centre)
  • DO NOT DRIVE to or from the hospital due to the possibility of low blood glucose readings
  • Check your blood glucose reading before leaving home if possible
  • Bring your diabetes tablets with you.
  • Bring your blood glucose monitor with you (if you have one)

If you have any questions or concerns;

  • Please contact the Endoscopy Unit between the hours of 8am - 6pm

Please follow the actions below starting:

  • 7 days before the day of your appointment if you take iron medications or day 4 before for all other patients.

Seven days before the procedure

If you are taking iron tablets please stop taking them, but continue all other medications including laxatives.

Four days before the procedure

If you are taking any constipating agents (e.g. loperamide, codeine phosphate etc.) stop taking them. Continue with all other medications until your appointment.

Three days before the procedure

Start following low fibre diet advice in the table below for your meals and continue following low fibre diet advice until you start taking your bowel prep medication the evening before your procedure. For the best results in cleansing the bowel a low fibre diet is advised. Eating other foods may affect how well the bowel preparation works to ensure good views of your bowel during your procedure.

Low Fibre Foods Allowed High Fibre Foods NOT allowed

White meat, including skinless chicken, grilled or poached fish

Red meats, bacon, sausages or pies, black pudding

White bread, toast, pasta, rice, noodles or boiled or mashed potatoes (no skins)

Breakfast cereals

Cheese, Eggs boiled or poached, Tofu

Wholemeal or seeded bread, wholemeal pasta or brown rice

Ice Cream, custard, clear jelly (NO red or blackcurrant), boiled sweets

Fruit, Vegetables or salad

Butter/margarine

Deep fried or roasted potatoes, potato skins or chips

Shredless marmalade or clear jam (no bits)

Nuts, pulses, lentils, beans

Clear soups

No other Biscuits than specified in foods allowed

Water, Tonic water, black tea or coffee sugar or sweetener

Milk

*Soft drinks (non fizzy) including squash (no red or blackcurrant)
^Clear fruit juices without pulp/bits examples clear apple or white grape

Fresh orange or juices with pulp Alcohol

Bovril

Crisps

*No added sugar, diet or low calorie soft drinks preferably.
^ Avoid drinking clear fruit juices unless blood glucose level is low.

The day before the procedure.

Breakfast and Lunch as usual-using foods from low fibre diet allowed list

Take your usual diabetes tablet(s)

Tea-Time (Evening meal) to be completed by 4pm-light meal using foods from low fibre diet allowed list

Diabetes medications with evening meal
Take HALF your usual evening dose of diabetes tablets unless you take only one tablet of any type of diabetic medication, then do not take any.

Following your tea-time meal even if you are hungry, do not eat any solid food after 4pm because this may impact on how the effectively the bowel prep works. Your bowel must be completely empty to ensure we have clear views during your endoscopy procedure.

7pm

Make up your first dose of bowel preparation
Follow the instructions for the specified bowel preparation sent to you. Drink as directed along with the additional fluids advised in the bowel preparation information.

You should not eat any further solid food until after your procedure.
However, you may drink clear fluids throughout the day. This should preferably be water, but you can also have tonic water, tea or coffee without milk, soft drinks (non fizzy) including squash (no red or blackcurrant) clear fruit juices without pulp/bits for example clear apple juice, Bovril.
^ Avoid drinking clear fruit juices unless blood glucose level is low.

Hypoglycaemia guidance

If any of your blood glucose readings are low (below 4 mmol/l), or you feel ‘hypo’ at any time:

  • Have a cup of FLAT Lucozade (170mls) or
  • One 60ml bottle of Lift drink (Lemon and Lime flavour only) or
  • 6-7 Dextrosol or Lucozade energy tablets or
  • 5 Glucotabs

Re-check your blood glucose after 15 minutes and if your blood glucose remains less than 4 mmol/l then repeat this treatment.

Once you feel better you will need to follow it up with longer acting carbohydrate foods. Choose one of the following:

  • 2 - 3 Rich Tea or Marie biscuits or 1 slice of white bread.
  • If your blood glucose remains low despite this treatment for over 30 minutes, please seek medical advice

The day of your procedure.

Do NOT eat any solid food until after your procedure
Do NOT take your usual morning dose of diabetes tablets
You may take clear fluids up to 2 hours before the time of your procedure preferable water

No later than 5 hours before you procedure appointment time:

  • Make up the second dose of your bowel preparation
  • Even if this means you getting up early

The second dose of bowel preparation should be made up in the same way as the first. Start drinking the bowel preparation at least 5 hours before the appointment time of your endoscopy procedure. Drink as directed along with the additional fluids using the guidance in the bowel preparation information.

For example if your appointment is:

  • 9am you need to take your bowel preparation at 4am
  • 10am you need to take your bowel preparation at 5am
  • 2pm you need to take your bowel preparation at 9am

On arrival at the Endoscopy Centre

When you arrive at the Endoscopy Centre your blood glucose will be checked and monitored by a nurse.

After your procedure

Your blood glucose will be checked before going home from the Endoscopy Centre.
Continue with your usual evening dose of diabetes tablets once you have eaten.