What to do with your diabetes treatment

Information for patients with diabetes taking ‘tablets’, ‘insulin or other injectable treatments alone, in combination or with tablets’ who require Upper Gastrointestinal or Respiratory Endoscopy Procedures AFTERNOON appointment.

This information aims to help you understand what to do with your diabetes treatment as you prepare for your gastroscopy, ERCP or bronchoscopy test.

Please read the information carefully it should provide you with all the information you need.

If you have any questions or concerns, please contact the Endoscopy Centre between the hours of 8am-6pm.

• You should have received an early AFTERNOON appointment no later than 2pm. Please contact the Endoscopy if you have not.
• 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 ALL your diabetes treatments with you.
• Bring your blood glucose monitor with you (if you have one).

On the MORNING of your procedure Breakfast

• Have a light breakfast no later than 07.30am

Your Diabetes Treatment

• If you usually take long acting insulin in the morning i.e. Levemir ® (Determir) or Lantus® or Toujeo® or Semglee® or Abasaglar® (Glargine) or Tresiba® (Degludec). Take this as normal.
• If you usually take any other insulin give HALF (1⁄2) your usual morning dose.
• If you usually take diabetic tablets take HALF (1⁄2) your usual morning dose of diabetes tablets. If you only take ONE tablet of any type of diabetes medication, then DO NOT TAKE IT.
• If you usually take Exenatide (Byetta®) or Liraglutide (Victoza®) or Lixisenatide (Lyxumia®) on the morning of your procedure, take your normal dose.
• Postpone taking your once weekly injection of Semaglutide (Ozempic®), Dulaglutide (Trulicity®), Exenatide (Bydureon®) until after the procedure if you usually take this on the same day as the procedure.

Do NOT take any more food for 6 hours before the time of your procedure.

You may take clear fluids (drinks without milk) for up to 2 hours before the procedure.

Lunchtime

• Do NOT have anything to eat
• If you usually take diabetic medication at this time, do not take this.
• Specifically if you normally take insulin at lunchtime, DO NOT TAKE THIS.

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

You will be able to have something to eat and drink once your swallow has returned after the local anaesthetic spray has worn off- unless there is a reason why you cannot.

You should continue with usual diabetic medication with your evening meal.

Hypoglycaemia guidance

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

• Have a cup (170mls) of Lucozade or approximately 200mls of full sugar cola/coke/Pepsi or
• One 60ml bottle of Lift drink (Lemon and Lime flavour only) or
• 6-7 Dextrosol or Lucozade energy tablets or 5 Glucotabs or
• Re-check your blood glucose after 15 minutes and if your blood glucose remains less than 4 mmol/l then repeat this treatment.
• If your blood glucose remains low despite this treatment for over 30 minutes please seek