I have a question I need to ask. In a week and a half (Friday the 8th) I have to go in and get 2 tests done. a colonoscopy and an endoscopy. Now I am a pumper, So my question is. since I have to litterally empty out everything of myself, what percentage should I adjust my basal to? 50%? 66%? 75%? remember there is no eating or drinking anything and there will be nothing in me. I don’t want to go hypo and have to eat. What do I do??? I am sure someone has some advice.
Hi Scottyd,
I had a colonoscopy this past August- I was on MDI then. Here is what I did: I lowered my basal doses by 1 unit each. I ate a soft breakfast the morning before and then went to liquids/jello and then the prep. Once you start the prep you won’t feel hungry, it makes you feel bloated/full. You can take glucose tabs(white or yellow) if you go hypo. I went hypo to 60’s once and took 1/2 glucose tab with a sip of water and I was ok after that. I let myself run high for the test and corrected after.
The prep was really awful for me so next time I will start eating a soft and liquid diet two days before to really clear myself out ahead of time and then go to the fast and prep. I was going to the bathroom for 19 hours- 3x right before the colonosopy- I don’t want to endure that again- I barely slept. I have ibs so that may have been why- one of the nurses I spoke with said that had happened to her.
I’m not sure if or how much you may need to reduce insulin for your pump. You are allowed to drink juices and have jello before the complete fast starts, before starting the prep. Just read the instructions they give you. I only drank water and then chamomile tea with the prep. I’m sure someone who has done this on a pump will give some advice about how they handled things.
The actual test wasn’t bad at all- I was totally knocked out with propofol- I had only a small amount of pain from gas after. Pre test my bg was 165, post test it was 185. I corrected and ate lunch when I got home ending up in the 110’s or so.
I think it’s a bit of a “seat of the pants” type thing.
My colonoscopy was scheduled in the morning. When I woke up and tested in the mid-80s, I dropped my basal rate to 70%. I also did a fingerstick test just before going in for the test to see how I was doing - high 80s. When I came to, I was in the 120s.
It is a hard subject to have a spontaneous, frank conversation about with the medical staff … or anyone for that matter. Cultural conventions make it feel very awkward, no? 
But I think you really should try to pump the team who’s going to be working on you with questions. While there are generally agreed upon … worst case paranoia based? 
… guidelines in medicine, each individual practitioner seems to have their own little quirks. If you can find a way to do it, I think it’s best to try to get a feel for the priorities of the folks who will be “your people” for this event.
If it were me, the first thing I’d want to know is what they think is going to happen with my pump & my BG while I am under anesthesia for the procedure. In the end I’m going to make my own plans as best I can. But it’s easier to do that if one has a feel for how the med staff thinks it’s going to work.
So I would ask them about how to handle a hypo should the need arise. I’d want to get a feel for how their minds work. Unfortunately I have only a vague recollection of details from when I went through this. I think the doctor made some glib, “shoulder shrug” comment about just taking some “Gatorade” to raise your BG during the liquids only phase of the prep.
My take on it is that the highest priority is to not clutter up your intestines, so I doubt the dextrose from glucose tablets (also known as “Smarties with posh pretensions”) would matter since it is absorbed so quickly.But doctors are the “inscrutables” of our time. Unless you ask them who knows what they might think.
As for dosages, I think as Emily said, it’s a bit of a “seat of the pants” type thing. Obviously you don’t want to have any “active insulin” remaining from a bolus. As for basal rates, I would want to try to get an idea how my BG was trending leading up to the procedure and then potentially temp basal it based on that. The stress of the situation might actually make you trend higher so low BG might not be a concern at all. 
Thank you all. I like the 70% number YogaO just I am picky so I would go 66%, and thank you also Meee, that must have been tough on you. you are a needler though (I think) , Now that would be “REALLY TOUGH Thanks for all the info and advice”.I am going to speak to my Endo before, and see what he says.
a 30% (70% of basal rate) reduction seems reasonable, if a 100% basal has been working well.
yw 
I’m on a pump now so what I would probably do for that is just adjust basal as needed- I do so many temp rates anyway according to what is going on bg wise. Like Yoga O said, everyone will have a different situation. It was pretty awful, at one point I was wondering if I would survive the prep and make it to the test, lol 
In terms of the bg I did very well though imo.
The main thing is you will get through it fine I’m sure. I would consider the liquid/soft diet in advance, many people said that made the whole process much easier for them. Test your bg before, they will ask you to do that, the procedure is normally only 15 minutes long so if you start with a good number with no iob the likelihood of going hypo is pretty small I would guess.
I had a good team in a hospital with interviews with the anesthesiologists, my doc and various nurses and interns right before. If you eat before or the prep doesn’t work they will reschedule the test so I would follow the directions and make sure it works so you don’t have to go through it again.
Mine was scheduled in the afternoon thankfully- I’m nocturnal and I tend to go hypo in the am.
ps. you’re not supposed to eat any red, purple or orange color foods/juices etc. before because this can be confused with blood and make things look different or make it harder to see what is going on. No seeds either I believe. There will be a full explanation of what to do in your prep instructions, call them with any questions. I did have 1/2 pink glucose tab and it didn’t affect anything.
I have had two colonoscopy and an many endoscopy. I have really never had a problem and I would always have them schedule procedure for early AM. I suffer from DP and a second phase BG rise when I get out of bead so there has never been much need for me to reduce my basal, I would not consider a correction until after recovery. I would skip breakfast and see what my reaction was if it was my first time. Before my transplant I had a endoscopy every three to six weeks for over two years never had a Hypo, my liver starts dumping glucose for hours after the Poly-glycol prep. Don’t do anything strenuous before the procedure that could burn off what little sugar is in your system.
Note: I have a good basal setting and have no problem skipping meals, anytime even two in a row.
My wife stays with me and checks my CGM and BG to make sure I’m not going low during recovery.
Thank you meee, . Now I know about you. (hehehe) I know all the info you gave, it was like reading it again. what a memory you have. the whole reason for the question, is that it is not just a c, but an e also,. and I just don’t want to go hypo, so I was mainly curious about the basal rate I should use. I know I will be fine, I have been through brain surgery to get my noggin working right again. (actually it was to stop seizures (it worked)) Now that I just now said that, I remember that they sent me to an endo, and he said to take the pump off and change to lanuts at a 50% of basal total l. (this was back in 2004). But now that was an 11 hour surgery.
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I’d recommend you monitor your activity before and during your prep. I had no choice but to run errands (1PM to 5PM) and with no carbs or change in my basal, I ended up going low, correcting when I tested at 53. I did lower my basal then (I looked back into my logs and I lowered my basal by 50%), which helped considerably; that, and I enjoyed a few (bolus-free) root beer barrels. In two hours I was stable with an 85.
My prep was different than what I understand is typical for other physicians of the same practice. I was given Suprep. I was allowed clear liquids from Noon until 5PM. At 5PM I began the fast and at 11PM and Midnight, I drank the Suprep. Odd, real odd. I was up through the night and was the first case of the day, getting there at 6AM for a 7AM colonoscopy. At 9:30AM I was discharged. After that, my husband and I went home to pick up our adult (college-aged) daughter and drove her an hour away, to a different health center, for a tonsillectomy and adenoidectomy. It was a long few days and then some.
I wish you the best of luck!
you’re welcome 
lol… I guess I have it ingrained into my memory permanently now lol I was very worried about hypos too, but only had one mild one and it was fine. In terms of the prep, upper endoscopy is easier for sure, but if you need both it’s better to get them done at the same time I think and only have one sedation. I’m glad your brain surgery worked! It must have been a lot to go through. I think this is so short that you can easily manage this on your pump. I would think a pump will make it easier to stay stable too. I forgot you’re getting them both done so it will be longer but not too much longer.
Thank you very much. I may have a lot of broken parts (hahaha) but my engine goes strong. I will be fine in the tests, but I am just curious. I have decided, because of what my endo said is to lower basal to 75%. I am going to be fine, but just curious. (like always) and it is just a test. the colonoscopy I have never had. but the endoscopy I have had multiple times. just keep your fingers crossed that the test comes out good. 
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