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 MORNING appointment.

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

Please read this 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 MORNING appointment between 8am-9am. Please contact the Endoscopy Centre 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

• DO NOT HAVE BREAKFAST

Your Diabetes Treatment

• Do NOT take your usual diabetes tablets.
• Do NOT take Exenatide (Byetta®) or Liraglutide (Victoza®) or Lixisenatide (Lyxumia®) if relevant on the morning of the procedure.
• 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 your morning dose of insulin unless you usually take long acting insulin in the morning i.e. Levemir® (Determir) or Lantus® (Glargine) or Tresiba® (Degludec) or Toujeo® or Semglee® or Abasaglar® then take this as normal.

Do NOT take any 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.

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.

If you have not had sedation for your procedure you will be advised to take your normal breakfast time insulin and/or your diabetes tablets when you eat (except your long acting insulin injection if already given on the morning of the procedure).

If you have had sedation it may take a little time for you to recover until you are fully awake and you will be advised when you next eat:

• If you usually take diabetes tablets in the morning take your usual dose when you have something to eat after the procedure.
• If you are on a twice daily insulin regimen take two thirds (2⁄3) of your usual morning dose when you have something to eat after the procedure.
• If you are on a three times insulin regimen have your usual lunch time dose.
• If you are on a four-times daily insulin regimen take your usual lunchtime rapid acting insulin dose.

• Continue with your usual treatment for your diabetes (insulin and/or tablets and/or injectable treatments) according to your usual practice) with your evening meal and at bedtime.

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 (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 it remains less than 4 mmol/l then repeat this treatment 
• If your blood glucose remains low despite this treatment for over 30 minutes seek medical advice.