I need help/advice re insulin before a colonoscopy

Hi All,
I was diagnosed with LADA in March of 2019. I take one 0.5 mg tablet of Prandin, one 100 mg tablet of Januvia and one 500 mg tablet of Metformin every morning, no insulin. I take a second 500 mg tablet of Metformin with dinner and five, six or seven units (depending upon my bedtime blood glucose number) of Basaglar before bed.

I am scheduled for a colonoscopy on the 18th of this month. I am not sure about how to proceed. It is clear in the instructions that I am not to take any of my oral medications the day of the prep or the day of the procedure. The instructions say to take one half my insulin dose on prep day and one half on procedure day. I assume that means I take half the dose of insulin before going to bed on prep night and just don’t take any before the procedure, which is scheduled for very early the next morning.

But what if my bg is very low when I test before bed on prep night? Or high because of the prep and clear liquids? And shouldn’t I be drinking non-diet soda so I don’t get a low bg? The instructions say I should test my bg before leaving my house on the day of the procedure and call my “Doctor or Endocrinologist if the sugar is under 65 or over 300.” (That doesn’t even sound doable at 5:30 am. Timing is a problem if my procedure is scheduled is at 6:30 am.)

And what if I have a very low bg in the morning? I can’t eat or drink anything until after the procedure according to the instructions.
What I want to avoid is getting to the test center and being told I can’t have the test because of my bg. Does anybody know how I should handle this? I have had colonoscopies before but not since my diagnosis and I am really scared.

Thank you so much in advance for any advice you may be able to give me.

If you are not taking insulin, I don’t see that you will have a problem with going low. I used sugar free white grape juice for my prep and if you use unsweetened liquids, you should not have a problem going high.

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I agree with @Don1942. Additionally, you want enough carbs on board to last a sustained fast (factor in a stress related bg rise) without being hypoglycemic. You don’t want to show up for your procedure hypoglycemic, or hyperglycemic. Most surgecenters (based on personal experience) won’t perform any procedure if you are under 75 or over 200 though ultimately it’s up to the dr, so exceptions may apply.

One other thing… you are better judge of your insulin needs than your dr. What you do to maintain a stable bg before you arrive at the surgecenter is need to know unless you have taken solid food <12 hours before. Personally my surgeons and anesthesiologists have always given me directions re: diabetes meds, but my Endo agreed that I am a more capable of managing my bgs than the drs are because I deal with it on a day in day out basis. Do what you have to do to maintain a reasonable steady bg and leave room in your calculations for a creeping stress rise or minor drop over time.

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I am not sure of anything because I don’t have really good control anyway. I lost 15 pounds when I got LADA and have not been able to gain even a pound back. I am 5’8" and weigh 110. I am going to my endocrinologist a few days after the colonoscopy and plan to get a script for a CGM and inquire about some fast-acting insulin for mealtimes. In the meantime if I follow the instructions I will take my insulin at bedtime on prep night and then not again until after the procedure. I want to know if you think I should take any sweetened drinks at all or stick to unsweetened. I don’t know what is in the prep either. I really appreciate the feedback from Don1942 and El-Ver very much. Thank you.

I have a colonoscopy scheduled as well. I bought sugar free and regular ginger
to manage the bg. What prep are u using. I am using Gavilyte

Talk to your doctor. He should have the best idea of what you should do. The medical facility where you have the procedure done should check your BS before and after the Colonoscopy and have juices in case you are running low.

I have to get a Covid test 1-3 days before the procedure

@mowo. Welcome to TuDiabetes.

Seeing your post about seeing your endo AFTER your colonoscopy and discussing a CGM then leads me to advance the question, “Can you flip your appointments?”. IF (and it is a BIG ‘if’, can you (and would it be wise) to postpone your colonoscopy until after you 1) possibly get a CGM and 2) have time to discuss in detail your diabetic meds to be taken around your colonoscopy.

Another point has happened in my past is worth sharing. IF you get a CGM, work with the crew at the colonoscopy center. I have had outpatient procedures with anesthesia. I work with my health care team all the way around and wear my CGM and insulin pump during the entire stay in the outpatient center. The anesthesiologist and recovery nurses really appreciate being able to monitor my blood sugar. I wear a pump that will decrease or shut off my insulin if my sugar is too low and conversely, give extra insulin if I get ‘too sweet’.

Bottom line, you must be your own advocate. You know what is safe if delaying the colonoscopy is acceptable. If you get a CGM, try to wear it during the colonoscopy. If you are not able to wear it, call the CGM technical support team, explain the situation and ask if they will send you a replacement sensor so you will not be without a sensor.

Best wishes. Keep us informed. Your sharing will help all of us learn new things.

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Docs don’t want you to consume anything, including liquids prior to performing a colonoscopy in case you get nauseous during the procedure.