Morning appointment (Moviprep®)

If you answer "yes" to either of the following questions, contact the diabetic specialist nurses (DSNs) immediately for further advice – you may need to be admitted in preparation for your colonoscopy.

Diabetic nurse specialists: 0121 371 4523 or 0121 471 4535

1. Have you recently needed admission to hospital because of your diabetes?
   No – continue
   Yes – contact DSN for advice
2. Do you have problems with hypos (low blood glucose levels)?
   No – continue
   Yes – contact DSN for advice

Eat as normal until 13:00 the day before the test. After this you should start a liquid diet.

Liquid diet can include the following clear fluids:

• Black tea or coffee (no milk)
• Water
  Fruit squashes (not fresh fruit juices)
• Clear carbonated and non-carbonated soft drinks
• Soda/tonic water, Lucozade, lemonade
• Stock cubes (Oxo, Bovril, Marmite)
• Clear soups
• Jelly

At 14:00 prepare sachets A & B of Moviprep®  in one litre of water (or mix with squash) and drink one glassful every 15 minutes until the jug is empty (make sure toilet facilities are nearby once Moviprep® has started).

Continue on a liquid diet (as above) overnight.

At 18:00 prepare sachets B & C of Moviprep® in one litre of water/squash and drink, as before.

If you take tablets for diabetes

1. Take tablets as normal on the morning of the day before the procedure
2. Omit all diabetes tablets after these morning doses and only restart diabetes tablets at lunchtime after the test

If you are taking insulin for diabetes

Four injections per day (short-acting with meals & long-acting pre-bed)

On the day prior to the colonoscopy:

1. take normal short-acting insulin at breakfast
   at lunch take ½ (half normal short-acting insulin dose)
   pre-bed take ½ (half usual long-acting insulin dose
2. You should check your home glucose values every four hours
3. On the morning of the test omit insulin until after procedure
4. You should have been given the (first) early appointment on the list. (If you do not have an early morning appointment – please contact the relevant unit so that your appointment can be altered)
5. After the procedure take ½ (half) normal short-acting insulin with a snack and return to normal insulin doses from lunchtime onwards

Two injections per day (twice daily pre-mixed insulin)

1. On the day prior to the colonoscopy take ½ (half) normal insulin doses at breakfast
2. You should check your home glucose values every four hours
3. On the day of the procedure omit morning insulin dose
4. After the test have half normal morning insulin dose with snack/early lunch
5. Have normal evening insulin dose with evening meal

One injection per day (long-acting insulin pre-bed) +/- tablets during the day

1. On the day prior to the colonoscopy:
   take tablets as normal at breakfast
   omit all diabetes tablets after these morning doses and only restart at lunchtime after the procedure
   Pre-bed take ½ (half) usual long-acting insulin dose
2. You should check your home glucose values every four hours
3. After the procedure have a snack and return to normal tablets from lunchtime onwards and normal insulin dose pre-bed

You should contact the Diabetes Specialist Nurse on 0121 371 4523 or 0121 471 4535 if you have any questions or concerns prior to the procedure.