Split-dose PEG for colonoscopy insufficient for bowel preparation in diabetic patients
Preparation quality for colonoscopy is worse in individuals with diabetes than those without, a recent study has found. In addition, diabetic patients also experience longer cecal intubation and total procedure time.
A single-centre, prospective, investigator-blinded study was conducted to compare the efficacy and tolerability of split-dose polyethylene glycol (PEG) for diabetic vs nondiabetic patients. A total of 50 diabetic and 55 nondiabetic patients ingested 2 L PEG solution on the day before the procedure and another 2 L of the solution on the day of colonoscopy.
Researchers graded the quality of bowel preparation using the Ottawa scale.
A significant difference was seen in bowel preparation quality. Diabetic patients had a worse preparation except for mid colon compared with nondiabetic patients (total score 7.06 vs 5.54; p<0.001; right colon 2.28 vs 1.81; p<0.001; mid colon 1.70 vs 1.56; p=0.253; rectosigmoid colon 1.70 vs 1.14; p<0.001; fluid volume 1.38 vs 1.01; p=0.001).
Adequate preparation was achieved in about 70 percent of nondiabetic patients vs only 40 percent of diabetic patients (p=0.003), which also had longer cecal intubation time (6.4 vs 4.5; p=0.002) and total procedure time (22.1 vs 18.1; p=0.015).
There was no significant between-group difference in compliance and adverse events. In the diabetic group, a significant association was observed between inadequate bowel preparation and higher fasting plasma glucose (136 vs 121.8 mg/dL; p=0.016).
The results indicate that split-dose PEG preparation regimen is not adequate for optimal bowel preparation in diabetic patients undergoing colonoscopy, according to researchers.
Split-dose PEG is considered a standard bowel preparation regimen for colonoscopy in the general population, they added.