Diabetic Management
Preparing for a Medical Procedure: Guidelines for Adults
What are my general guidelines?
-
If you wear a Continuous Glucose Monitor, you must remove it for all CT scans, MRIs and X-rays.
-
If you have Type 1 diabetes check your urine for ketones when your blood sugars are greater 250mg/dL. If you have moderate or large ketones, contact your health care provider to manage this condition.
What should I bring?
Testing supplies (glucometer, test strips, lancing device.)
o You will use this when you are traveling to and from the procedure.
What are my pre-procedure instructions?
Night before procedure
o Test your blood sugar at dinner and bedtime and whenever you feel
that you might be experiencing low blood sugar or very high blood
sugar.
o See “How do I adjust my medication before the procedure?” section
below.
• Morning of the procedure
o Test your blood sugar first thing in the morning of the procedure. Continue to check your blood sugars every 1-2 hours up to your procedure and whenever you feel that you might be experiencing low blood sugar or very high blood sugar.
o See “How do I adjust my medication before the procedure?” section below.
• If you have a low blood sugar
o You must treat all low blood sugars. If your blood sugar is less than
70mg/dL, drink 1⁄2 cup of clear sugar-sweetened beverage such as apple juice, Sprite or 7UP (all liquids must be clear). Recheck your blood sugar in 15 minutes. If your blood sugar is still less than 70mg/dL, drink another 1⁄2 cup of clear sugar-sweetened beverage.
o If your blood sugar is extremely low (less than 40mg/dL), your family or friends should help you by using glucagon and calling 911 if needed. Make sure that you also call 5203825972 to notify the procedure team.
*If you need to treat a low blood sugar within 2 hours before your procedure, call to inform your procedure team. Your procedure may need to be rescheduled.
If you are doing a bowel prep and need to follow a liquid diet:
-
See “Pre-Procedure Instructions” above for instructions on what to do the
night before your procedure.
-
When drinking sugared beverages or the bowel prep, you may need less
insulin to cover the carbs you are drinking. This is because sugary liquids will leave your system more quickly than solid foods and you will be drinking these liquids slowly throughout the day. If you take insulin with food, give 50% (half) of your usual dose for the liquids you are drinking that have carbs.
How do I adjust my medication before the procedure?
Stop taking the following oral medications 2 days before your procedure:
Empagliflozin (Jardiance)
Dapagliflozin (Farxiga)
Canagliflozin (Invokana)
Ertuglifloxin (Steglatero)
Dapagliflozin/Metformin (Xigduo XR)
Dapagliflozin/Saxagliptin (Qtern)
Canagliflozin/Metformin (Invokamet & Invokamet XR)
Empagliflozin/Linagliptin (Glyxambi)
Empagliflozin/Metformin (Synjardy & Synjardy XR)
Ertuglifloxin/Sitagliptin (Steglujan)
Ertuglifloxin/Metformin (Segluromet)
If you are using U-500 insulin or another insulin not listed on this sheet, ask your provider how to adjust your medication. Always follow instructions given to you by your provider.