Hi,

I am scheduled for my first colonoscopy next week.

I assume I can wear my pump, since I was able to wear it during my hysterectomy. Is that right?

I assume I should REMOVE my MMM RTMS sensor, or at least disconnect the minilink and turn the system off so it does not beep during the procedure.
I am planning to decrease my basal by 50% the morning of the procedure, since his directions say to take 1/2 the normal insulin dose. He wants me to be on the high side, although he did not tell me how high.

The doctor requires a liquid diet for 2 days, with the serious prep starting at 4 PM the day before the test.
I was told I can drink the following as long as it is not red, blue, pink or purple in color:
Water
Gatorade
Spite, 7Up, Mountain Dew (thank goodness since it has caffeine!, Fresca
Apple juice, white grape juice
Jello
Popsicles
Sorbet as long as it does not have chunks of fruit

How many grams of carbs would you eat for each meal? Or should I consume these items more often than meal times?

Any help would be appreciated.

Thanks,
Linda

Linda
Liquid modified diets are a pain! I have had to do some fasting and liquid diets also. If you are on a pump you just bolus for the carbs in whatever you want to drink. My basal rquirements decrease during fasts so lots of checking and ask your endo about a possible reduction in your basal amount that last 24 hours. If you are on MDI you really need to get information from your endo-not the nurse but the endo himself. Most of the nurses who answered my calls just gave me standard advice for anyone, their tip sheet did not deal with type ones I really had to push to get through to my endo to find out what he wanted me to do. This always comes up with the cholest. screening or surgery prep where they want no calories in your system, my endo always allows some sugar for lows. Get extra strips and do lots of fingersticks. If your are MDI you could try to just cover your typical carb amount with an equal amount of liquid carbs-does not work exactly but pretty close. I tended to just not drink much of anything and just drink carb liquids to compensate for lows for the last 24 hours. Good luck. lisa

Linda - I was put under for surgery two years ago, but it did not involve a liquid diet - I was NPO for 12 hours before.

As for the liquids, I would just bolus for what you drink...

When it came to my surgery, I set my pump at 50% basal for 6 hours, starting 1 hour before surgery. My dr taped my pump on my chest. I started the surgery at 8.3, and came out of it all several hours later at 11 mmol/l.

I was nauseated for the next several hours and had to corrected several rises, but the 50% decrease worked and made my dr feel more comfortable...

Drea
You are lucky! When I had surgery last year they just pulled my site out and when I came to in the recovery room I had no idea when they had pulled it, no idea how much glucose or insulin via the IV they had given me during surgery. I had gone through all my needs pre surgery and nothing was really communicated to the surgery staff or it was and they just ignored! It was unbelievable-it took me 24 hours to get things back in order. lisa

"When it came to my surgery, I set my pump at 50% basal for 6 hours, starting 1 hour before surgery. My dr taped my pump on my chest. I started the surgery at 8.3, and came out of it all several hours later at 11 mmol/l.

I was nauseated for the next several hours and had to corrected several rises, but the 50% decrease worked and made my dr feel more comfortable..."
[/quote]

Lisa - that is really strange that they pulled your site out. I told the Dr only to pull the site out if things went wrong and I did not wake up

BUT one thing I would have done differently - I had no one else with me who knew how to use my pump. My parents came into town to take care of me after the surgery (which I was really thankful for!!)....but they do not know how to use my pump or know anything about it. No one really does but me.....I likely should have shown someone the basics or given them the tools in case they needed to adjust my temp rate or correction bolus for me!

I was going to ask the exact same questions Linda did - I am having a colonoscopy next week, and I have the same questions Linda did. There wasn't a lot of advice to her original questions.

Does anyone have any further advice? This whole liquid diet deal has me pretty freaked out. I'm supposed to drink 64 oz of Gatorade the evening before the procedure. That's 112 g carbs! Holy cow! Since most of that's probably going to come right back out, should I bolus for that much? I don't even eat 112 g of carbs at Thanksgiving!

Linda, what did you do? The closer it comes to this deal, and the more I read the directions, the more I am tempted to just blow it off. I really don't want to do this.

Tom

Tom,

I'm not sure exactly what I did, but I think I bolused for everything I ate and drank. I had to do it for two days! Even though you wind up with diarrhea, I assume the sugar still reaches our bloodstream and raises BG accordingly. I know the liquid diet sounds awful, but it wasn't that bad or that hard to do.

It is really important to have the test done - don't blow it off. When Ed had his done they found a huge polyp that would have become cancerous if it had not been found and removed.

Linda B.

linda

I had a CO and didn't slow my pump down any where near 50%. If I did, I'd be sky high. Every time I do a fasting blood test, my bg's go too high by the time I'm at the lab, so I've learned not to turn my pump down except for extreme circumstances. I've had lots of procedures and surgeries and my pump basal rate usually runs at normal, or if I see I'm under 100, I'll turn it down a bit for an hour and that prevents me getting hypo.

To heck with a doc who wants MY bg's to run "high". I do the best I can to keep it over 100 but well under 160. Most of the time it works out fine, but that's because I don't take direction from the anesthesiologist or surgeon when it comes to managing my bg's. I know better than them, as my many experiences with surgery have borne out.

Tom

I cant believe there doing that; because of my "betes" they just have me drink a prep starting at 6pm the night before the proceeder and
ask me to eat soup,yogurt no heavy meals the day before the prep and of coarse nothing with psychedelic colors.

What they give me is Polyethylene Glycol, it has no active ingredients and doesn't deplete your electrolyte's your body will not absorb any of it.
One ten oz glass every 20 min, and it's fast and effective. Then they will let me drink some apple juice if my BG is to low before the procedure.They
always schedule me for the first time slot in the am usually around 7am. They will set up an IV too administer the knockout med's make sure it's
ringers and not that evil glucose drip.

Make sure the peon that set up your procedure understands that your a T1. (64 OZ OF GATORADE "WOW") If you actually drink the Gator
let us know how that works out.

Don't back out of doing this procedure , everyone needs to have this checkup. I think they just gave you the standard instructions for the average Joe blow.

JohnG

I am thisclose to blowing this thing off. I really don't think I trust this doc. I'll have the thing done, but I need to find someone that knows about D. My doc at the Joslin center couln't refer me to anyone, but I think I want to find someone other than this one.

I'm supposed to take a couple of different laxatives - Dulcolax and Mirolax (mixed with the huge bottle of gatorade). I still can't figure out how to bolus for the Gatorade, so I'm thinking this is not a good idea until I know exactly what I am doing to myself.

Tom

I wish I still had my instructions, but I can tell you that I mixed that stuff with something that did NOT have carbs (suggested by my doc's office). NOT Gatorade. All you want is to somewhat to disguise the awful taste of what you are mixing into it. I don't think it matters what that is. You should call and ask about this. If you must drink the Gatorade, I would definitely bolus for all the carbs (that's awful) because, like Linda said, I'm sure you will absorb the carbs before you dispose of the liquid.

As for the liquid diet, I ate what I felt like eating of the stuff I was allowed (same as you), and bolused for whatever carbs they contained.

I reduced my basal by about 30% several hours before the procedure (used a pattern). And they agreed that if I was lower than I wanted to be before the procedure, I could have glucose tabs (not pink ones).

I kept my pump and sensor on me but I don't remember if I turned off either or both of the alarms.

Barbara

To Linda B,
Yes, you can wear your pump during a colonoscopy or during surgery. Even if you have to fight for it. When I had rotator cuff surgery, they wanted to remove mine and I had to insist with the anesthesiologist and the surgeon. I finally told them that my endo wanted it, and he happens to be the Chief of Endo in the hospital. They finally yielded and all went well with the pump. I made sure that my BG was at 150 and I don't recall exactly how much I reduced my basal, but perhaps .2 (it is usually 1.2). Or it could have been .9 but no less than that. Of course, you know enough about your basal that you should use your judgment on that.

The only thing you can't keep it on for is when you have an MRI. Or unless you are having some procedure that involves magnets!

Tom,
I hope you will get the procedure and can figure out how best to deal with the requirements. I've not had this yet but my doc is making sure to 'prepare' me when the time comes. I think if you are not confident that your doc is handling your first and main issue then you should seek someone who will. This procedures is nothing new to the medical community and neither is a diabetic having one. Good luck to you

I got myself worked up into such a lather about this I wound up calling the doc's office this morning. I'm having the procedure tomorrow, and today is a holiday in the U.S., so I couldn't call the doc who's doing it.

Anyway, the doc that was on call sounded surprised I wasn't instructed to get sugar-free Gatorade. He had a brand name for it, but I couldn't find it, but I got sugar-free Powerade. I feel a lot better about things now.

Today is the first morning I've skipped breakfast since I did a morning basal test more than 2 years ago. The good news about this whole deal is that my morning basal seems to be just right for now.

Tom

In two years, you haven't had a single fasting blood test of any kind?

Lots of people eat their breakfast after the fasting blood is drawn.

I had my colonoscopy today, and all went well. I am very grateful for everybody's replies about my anxiety with the Gatorade. You all gave me enough knowledge to finally break down and call and get an alternative to the Gatorade (112 g carbs?!? - I've never bolused for that many carbs!).

Anyway, the sugar free stuff I got worked just fine, and during the procedure, they just removed a couple of small polyps. There is minor evidence of diverticulosis, but nothing to get worked up about - just start eating more fiber.

Once again, thanks for everyone's help.

Tom

PS to Nel-wnc - I'm sorry you got confused because I revived this 2-year old thread, but I thought Linda's original post had exactly my questions, so I just added to it. I will think harder in the future about reviving old posts - and strongly consider starting a new thread. Your advice about lowering the basal was beneficial, so I appreciate your comment. I lowered mine 20%.

Tom,

Thanks for the update, that was great that you let us know the results and how you managed. Good news is welcome always, even in revived threads! I'll probably revive this in a year or so when my turn comes up LOL

Glad to hear everything went well. Were you out or did you have sedation?

Tom,

I've never had a colonoscopy and hope I never have to! I'm glad to hear that everything went well. I worked in a pharmacy after school in high school and I remember a lot of people getting prescriptions filled for a big (gallon?) sized jug with powder in it. They were to fill it with water and drink it before a colonoscopy. Gatorade sounds like a better option but I wonder if that prescription stuff had other ingredients in it.

I was not put under general anesthesia, so I was just heavily sedated. I forgot the exact term they used for it. I do know I felt it - I've never particularly cared to have things shoved up my ... well, you know.


Well, you can hope all you want, but the fact is, you will need one within a few years! Your doc(s) will start bugging the hell out of you to get one done.

I mixed a powder in with the Gatorade - I think it was called Miralax, but it was an over-the-counter deal. I know it worked.

Tom

Tom,
It's a good thing you had this done now. I'm sure they explained that polyps are often pre-cancerous. I'm glad you didn't wait.

Linda B.

Actually everyone is advised to have one after the age of 50. Most people don't have them because they have to. Many a pre-cancerous polyp has been found and removed during a colonoscopy. I never heard of gatorade for a colonoscopy. There are different kinds of preps but they all have the same objective.

That is probably conscious sedation? I've had that, but for the last two I had propofol

I guess the Gatorade was to mask the vile taste of the powder.

Well, I've got a few more years to go before 50 although not as many as I'd like!

Maybe by then they will have a better procedure.

I know this is an old thread, but I'm reviving it because I had my first colonoscopy today. Everything was fine (no polyps). My family doctor suggested that I get because I had turned 50.

Some things may have changed in the past 2 years. The preparation seems to be similar still (the 4 powder packs of Klean Prep) plus another drug. The instructions that I had suggested mixing with 50% water and 50% clear juice (such as apple juice). I think I used about 75% water and 25% juice (because I found it tasted too sweet with 50% juice). Surprisingly, my blood sugar dropped during the prep time (even after I stopped bolusing for the juice). I ended up setting a 50% basal for the procedure but forgot to reset the temporary basic after.

The clinic that I went to was familiar with insulin pumps. The have an instruction sheet for the procedure that also includes specific instructions for people with diabetes. Because this was a clinic (and not a hospital), I had to see a cardiologist and a nurse educator at my initial screening in the clinic. They both told me since I was on a pump to speak with my diabetes nurse educator about settings for the pump. (I already had practice fasting since I fast on all the Jewish fast days; the liquid diet is earlier to manage than a full fast).

I had conscious sedation. It was expected that I would keep the pump during to procedure to continue receiving the basal insulin and they had no problem with the sensor being in and working.

I had a colonoscopy a couple months ago. The preparation was a foul liquid called moviprep, and there was a 12 hour fast before the procedure. During the fast I started with a 50% temp bolus but then adjusted it to 60% which seemed to keep me more stable. Before the procedure I showed the anesthesiologist my pump and CGM. He wanted my BG over 100 and flat or slowly rising so that I likely wouldn't go low. He was quite comfortable that I keep the pump going (at 50%), and actually liked the CGM. He said he would have an official BG measurement using the facility's equipment at the start, but that he might check the CGM from time to time just in case it would show anything dramatic. (I got the impression that normally they would have no continuous BG information, only a BG measurement every hour.) He did have me set the alert silence for 1 hour more than the scheduled length of the procedure.