Inadequate Bowel Cleansing Efficacy Of Split-Dose Polyethylene Glycol In Diabetic Patients For Colonoscopy: A Prospective And Blinded Trial

Su1521 Inadequate Bowel Cleansing Efficacy of Split-Dose Polyethylene Glycol in Diabetic Patients for Colonoscopy: a Prospective and Blinded Trial Young Hwan Kim*, Eun Hee Seo, Seung Heon Lee, Jae Seung Lee, Sung Ho Choi, Hee Seung Park Division of Gastroenterology, Department of Internal Medicine, Busan St. Mary’s Hospital, Busan, Korea (the Republic of) Background/Aims: The split-dose PEG is considered the standard bowel preparation regimen for colonoscopy. The aim of the present study was to compare the efficacy and tolerability of split-dose PEG for diabetic versus non-diabetic patients who underwent scheduled colonoscopy. Methods: Single-center, prospective, investigatorblinded study. A total of 50 consecutive non-diabetic and 45 consecutive diabetic patients requiring colonoscopy were instructed to ingest 2L PEG solution on the day before the procedure and then 2L of the solution on the day of colonoscopy. The quality of bowel preparation was graded using the Ottawa scale, including cleanliness and fluid quantity. The patient tolerability was assessed using a patient questionnaire. Results: There was a significant difference between diabetic and nondiabetic patients for bowel preparation quality using Ottawa scale, with a worse preparation except mid colon in the diabetic group (total score;7.20 1.64 vs. 5.40 1.96, p! 0.001, right colon; 2.31 0.56 vs. 1.76 0.72, p! 0.001, mid colon; 1.71 0.55 vs. 1.54 0.64, pZ0.170, rectosigmoid colon; 1.78 0.74, p!0.001, fluid volume; 1.40 0.54 vs. 1.00 0.61, pZ0.001). A total of 72% (36/50) of the nondiabetic patients had an adequate preparation (total Ottawa score % 6) compared with only 38% (17/45) of the diabetic patients (PZ 0.001). Patient compliance and incidence of adverse events were not significantly different between the two groups. There was no difference regarding polyp and adenoma detection rate. In the diabetic group, inadequate bowel preparation (total Ottawa score O6) had a significant association with fasting plasma glucose (FPG) (mean FPG of group with inadequate bowel preparation vs. adequate bowel preparation; 136.4 22.5 vs. 121.9 21.0, PZ0.037). But other factors including age, duration of DM, requirement of insulin, HbA1c and late complication including nephropathy, retinopathy and neuropathy had no relationship with inadequate bowel preparation. Conclusion: Although diabetic patients were tolerable to split-dose PEG preparation regimen as non-diabetic patients, they had a worse preparation quality compared with non-diabetic patients. These data suggest that split-dose PEG preparation regimen is still not sufficient for optimal bowel preparation in diabetic patients undergoing colonoscopy.