[Bowel preparation in patients with Diabetes mellitus: Development of a procedure model]

Adequate bowel preparation prior to colonoscopy is the key factor for high quality preparation for colonoscopy. Inadequate preparation can result in prolonged procedure time, incomplete colonoscopy and an increased risk of procedural adverse events. Diabetes mellitus has been identified as a predictor of inadequate colonoscopy bowel preparation. Currently, standard recommendations for diabetes patients before colonoscopy are missing.

This review is based on a selective literature search in PubMed and Google Scholar carried out in June 2021. Systematic reviews, guidelines, expert opinions, and recommendations from German and international societies were also considered.

The currently available preparations comprise two different groups: High-, medium- and low- volume polyethylene glycol (PEG) preparations and hyperosmotic agents. So far, a couple of reviews tried to identify outcome related differencies. Results are heterogeneous. In practise, preparation agents and timing of preparation as well as a thorough patient information before the preparation process are considered the most relevant items. In diabetes patients, preinterventional dietary recommendations are of paramount importance.

Split dosing of PEG preparations are recommended in diabetes patients with expected motility disorders. Extensive counseling about preparation intake and dietary recommendations should be offered.