title: Inadequate Bowel Cleansing Efficacy of Split-dose Polyethylene Glycol for Colonoscopy in Type 2 Diabetic Patients: A Prospective and Blinded Study.
abstract: OBJECTIVE
  Split-dose polyethylene glycol (PEG) is considered a standard bowel preparation regimen for colonoscopy in the general population. However, it is not clear whether the regimen is optimal for colonoscopy in diabetic patients. The aim of this study was to compare the efficacy and tolerability of split-dose PEG for diabetic versus nondiabetic patients.
  
  
  METHODS
  This is a single-center, prospective, investigator-blinded study. A total of 55 consecutive nondiabetic and 50 diabetic patients ingested 2 L PEG solution on the day before the procedure and then 2 L of the solution on the day of colonoscopy. The quality of bowel preparation was graded using the Ottawa scale.
  
  
  RESULTS
  There was a significant difference in bowel preparation quality, with a worse preparation except for mid colon in diabetic group (total score: 7.06±1.69 vs. 5.54±1.97, P<0.001; right colon: 2.28±0.57 vs. 1.81±0.72, P<0.001; mid colon: 1.70±0.54 vs. 1.56±0.66, P=0.253; rectosigmoid colon: 1.70±0.76 vs. 1.14±0.62, P<0.001; fluid volume: 1.38±0.53 vs. 1.01±0.59, P=0.001). About 70% of nondiabetic patients had an adequate preparation compared with only 40% of diabetic patients (P=0.003). Diabetic group had longer cecal intubation time (6.4±3.6 vs. 4.5±2.4, P=0.002) and total procedure time (22.1±7.6 vs. 18.1±8.5, P=0.015). Compliance and adverse events were not significantly different. In diabetic group, inadequate bowel preparation had a significant association with higher fasting plasma glucose (136.9±21.8 vs. 121.8±19.4 mg/dL, P=0.016).
  
  
  CONCLUSIONS
  Diabetic patients had a worse preparation quality and longer cecal intubation and total procedure time compared with nondiabetic patients. These data suggest that split-dose PEG preparation regimen is not sufficient for optimal bowel preparation in diabetic patients undergoing colonoscopy.
authors.affiliation: Departments of *Internal Medicine, Division of Gastroenterology †Internal Medicine, Division of Endocrinology, Busan St Mary's Hospital, Busan, Republic of Korea.
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Kim
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Seo
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Lee
authors.forename: Seung Heon
authors.initials: SH
authors.lastname: Lee
authors.forename: Hee Seung
authors.initials: HS
authors.lastname: Park
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Ja Young
authors.initials: JY
authors.lastname: Park
authors.forename: Chang Won
authors.initials: CW
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002400:Cathartics / Q000008:administration & dosage*; D003111:Colonic Polyps / Q000000981:diagnostic imaging; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging; D003924:Diabetes Mellitus, Type 2; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002400:Cathartics; D011092:Polyethylene Glycols