Evaluation of safety of insulin degludec on undergoing total colonoscopy using continuous glucose monitoring

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Abstract

Aims/Introduction:

There is little information regarding how to use insulin degludec (D) when diabetic patients are preparing for total colonoscopy (TCS).

Materials and Methods:

A total of 12 patients with type 2 diabetes treated with insulin D and scheduled to undergo TCS were enrolled in the present study. A continuous glucose monitoring device was attached to each patient for 4 days, from two evenings before TCS to the morning after the procedure. The patients fasted for 24 h, starting after 18.00 h the day before TCS. Insulin D was only discontinued the morning of the day TCS was carried out.

Results:

No patients experienced hypoglycemia during the daytime fasting period (08.00–18.00 h the day of TCS); the hypoglycemic index, mean glucose level, and standard deviation were 0, 141.3 ± 31.5 mg/dL and 15.6 ± 6.5 mg/dL. The mean glucose level and standard deviation during the daytime fasting period were significantly lower than during the daytime control period (08.00–18.00 h the day before TCS; P = 0.003, P = 0.001, respectively). The mean fasting glucose and fasting plasma glucose levels were significantly correlated (r = 0.78, P = 0.002), as were both the mean glucose level and standard deviation during the daytime control period, and the change in the mean glucose level (fasting period minus control period; r = −0.79, P = 0.002, and r = −0.69, P = 0.01, respectively).

Conclusions:

Patients can safely undergo TCS when insulin D is discontinued only once on the day of the procedure.

In patients taking agents with a long-acting profile such as insulin degludec, hypoglycemia may consistently occur during preparation for colonoscopy (TCS). In this study, we showed patients treated with insulin degludec could safely undergo TCS with no hypoglycemia and minor variability of glucose level using a continuous glucose monitoring device.

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