Annual Scientific Meeting
Introduction: Currently, no standardized recommendations exist for management of antidiabetic medications in diabetes mellitus type II (DMII) patients undergoing bowel cleansing for colonoscopy. This study aims to find real-world practices of gastroenterology providers in the management of anti-diabetic medications in peri-colonoscopy period for DMII patients.
Methods: An online survey was created using Google Survey and sent to thirty-three providers who are routinely involved in planning colonoscopy for patients at our tertiary medical center. Survey questions were designed to know provider practices regarding the management of anti-diabetic medications on the day before and morning of colonoscopy in DMII patients. Questions specific to six non-insulin medications and four insulins (short, intermediate, long-acting, and mixed) for each meal were framed. Two expert endocrinologists were consulted to give best practice recommendations regarding management of same anti-diabetic medications in the peri-colonoscopy period. The answers from each provider were collected and summarized.
Results: Among 33 providers, 24 providers (72.7%) answered the survey. Of them, 12/24 were attending physicians, 6/24 were fellow in training, 6/24 were nurse practitioners/physician assistants). Table 1, 2, and 3 summarize the cumulative numbers (and percentages) for each response specific to each anti-diabetic medication and time of day.
Discussion: Our survey shows marked disparity amongst gastroenterology providers (attendings, fellows, and nurse practitioners/physician assistants) and with regards to endocrinologist recommendations. Lack of consensus leads to confusion at the patient level, often leading to mismanagement and sometimes even clinically significant hypoglycemic and hyperglycemic events. Gastroenterologists should team up with endocrinologists to come up with practice guidelines to standardize peri-colonoscopy management of anti-diabetic medications among DMII patients.