Developing a Colonoscopy Preparation Protocol for Patients With Diabetes

Patients with diabetes have less effective colonoscopy preparation when compared to nondiabetic patients. This leads to the possibility of missed polyps, longer procedural time and patient dissatisfaction. Furthermore, the peri-colonoscopy period has been associated with increased risk of hypoglycemic events given the required change in diet and possible changes in antihyperglycemic medication regime, though this area is not well studied. Studies have found that same day preparation for colonoscopy allowed for comparable bowel visualization to split dosing. Pairing this with a low fiber diet permitted the day prior to colonoscopy, the extent of changes to routine and diet within a patient with diabetes day for colonoscopy preparation is minimized and could reduce risk of side effects and hypoglycemia, while also ensuring adequate bowel preparation. This study tests the hypothesis that creating a diabetic specific protocol (permitting a low fibre diet the day prior to colonoscopy and using same day preparation) will result in fewer hypoglycemic events and more adequate quality preparation in comparison to a conventional 2L PEG split day preparation with dietary restrictions in patients with diabetes.

Inclusion Criteria: 1. Patients Age over the age of 18 2. Able to read and understand the English language 3. Confirmed diagnosis of diabetes (Type 1 or Type 2) Exclusion Criteria: 1. Patients without diabetes 2. Patients with prior hospital admission due to hypoglycemic events 3. Patients who have inflammatory bowel disease 4. Patients with ileus or bowel obstruction 5. Patients with history of colorectal resection 6. Patients receiving combined upper and lower endoscopies 7. Patients with ascites 8. Patients with previously documented severe renal impairment 9. Unable to provide consent 10. Pregnant or lactating female (females of child-bearing potential will undergo urine pregnancy testing) 11. Patients who have had a recent myocardial infarction(\<6months) 12. Allergy to product ingredients