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University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository

Specialty

General Surgery

Advisor

Dr Nancy Reid

Abstract

The quality of bowel preparation is essential for adequate visualization of precancerous or cancerous polyps in the colon. Patient compliance with colon preparation instructions directly impacts the quality of visualization. Previous studies have reported that diabetes mellitus is an independent risk factor for inadequate bowel preparation.1-3Current guidelines do not recommend a specific preparation for diabetic patients. Commonly, prior to mechanical bowel prep, a clear liquid diet (CLD) for 24 hours and a low fiber diet for 3-4 days is recommended. For diabetic patients, compliance and tolerability with a clear liquid diet (CLD) can be very difficult. It can lead to episodes of hypoglycemia or poor bowel prep. Research shows when patients feel hypoglycemic while on the clear liquid diet, they consume non-clear liquid calories, which leads to poor prep or cancelation of procedure. Published literature has shown that inadequate bowel preparation is linked to missed adenomas, increased interval cancer rates, increased procedure time, and increased healthcare costs due to the repetition of colonoscopic exams.4

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