Advice for diabetic patients taking insulin: Procedures involving barium • • • Barium meal and barium swallow Barium enema, per oral pneumocolon, small bowel enema or small bowel meal Barium meal and barium swallow
It is vital that the time of the appointment for your investigation is early in the morning (9-9.30 am at the latest). Please seek further advice if necessary from your Diabetes Day Centre. On the day of the examination (early morning appointment): Do not take your usual insulin Test your blood glucose on waking: if it is less than 4 mmol/L treat as a hypo with dextrose tablets, not liquid carbohydrate. Take insulin supplies, blood testing kit, dextrose tablets and a sandwich to the hospital with you. If your blood glucose falls to below 4 mmol/L at any time, treat with dextrose tablets. Immediately after the examination is finished take your usual dose of insulin and eat your sandwich. Then continue your day as usual If the examination has not finished by 11 am do not take your usual insulin but proceed as follows: If you usually mix clear and cloudy insulin together in a syringe take your clear insulin dose only before lunch and then continue with your usual insulin before the evening meal. If you usually take a premixed insulin e.g. Humulin M1, M2, M3, M4 or M5 or Mixtard, please ring your Diabetes Day Centre for advice on what to do. If you take only one injection a day please ring the Diabetes Day Centre before the date of the examination and discuss what to do! For Barium enema, per oral pneumocolon, small bowel enema or small bowel meal: It is vital that the time of the appointment for your investigation is early in the morning (09.00-09.30 hours at the latest). Please seek further advice if necessary from your Diabetes Day Centre. There is dietary preparation with Picolax or Citramag
Test your blood glucose four times a day. Increase your intake of sugary drinks if your blood glucose falls to below 4 mmol/L. On the day before your examination: Take your usual doses of morning and evening insulin. For breakfast, drink as much clear fluid as you want but only one cup of tea or coffee. You may have a boiled egg with 2 slices of white bread or a bowl of corn flakes with skimmed milk. 12 pm - 2 pm You may have a portion of chicken or fish. Have at least 2 tablespoons of white rice or 2 slices of white bread or a jacket potato without the skin or boiled potatoes or 4 tablespoons of white pasta. Do not eat vegetables. 4 pm - 7 pm Drink as much clear liquid as possible but not more than one cup of coffee or tea. Sip sugary drinks if necessary (e.g. ordinary coke) during the evening to keep blood glucose above 4 mmol/L. 7 pm - 9 pm Replace portions of carbohydrate (starch) containing foods with sugary fluids (see starch food exchange list). 10 pm Replace bedtime snack using suggestions on starch food exchange list. On the day of the examination (early morning appointment): Do not take your usual insulin Test your blood glucose on waking: if it is less than 4 mmol/L treat as a hypo with dextrose tablets, not liquid carbohydrate. Take insulin supplies, blood testing kit, dextrose tablets and a sandwich to the hospital with you. If your blood glucose falls to below 4 mmol/L at any time, treat with dextrose tablets. Immediately after the examination is finished take your usual dose of insulin and eat your sandwich. Then continue your day as usual. If the examination has not finished by 11 am do not take your usual insulin. If you usually mix clear and cloudy insulin together in a syringe take your clear insulin dose only before lunch and then continue with your usual insulin before the evening meal.
If you usually take a premixed insulin e.g. Humulin M1, M2, M3, M4 or M5 or Mixtard, please ring your Diabetes Day Centre for advice on what to do. If you take only one injection a day please ring the Diabetes Day Centre before the date of the examination and discuss what to do. STARCH FOOD EXCHANGE LIST The following provide approximately 1 portion of carbohydrate: 1 slice of bread 1 medium chapatti 1 medium potato 1 serving spoon of rice or pasta 1 digestive biscuit 1 bowl of breakfast cereal 1 packet of crisps 1 piece of fruit e.g. a banana 1 yogurt 1 glass of milk THESE CAN BE EXCHANGED FOR: 1/4 glass (50ml./2 fl.ozs) Lucozade with 1 teaspoon of sugar 1/2 glass (100ml./4 fl.ozs) of ordinary coke with 1 teaspoon sugar 1 cup of black tea or coffee with 2 teaspoons of sugar 25ml./1 fl.ozs undiluted Ribena made up to taste with water. (Drinks must not be fizzy (this affects the investigation). Sugar can be added and the liquid stirred to remove the fizz.