ABSTRACT

This presentation fosters awareness about how the type of colonoscopy preparation impacts Boston Bowel Prep Scores (BBPS) in diabetic patients. Diabetes and some medications for managing diabetes, such as glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT2) inhibitors, delay gastric emptying and lower BBPS. During colonoscopy, lower BBPS are associated with lower polyp detection rates and higher interval cancer rates. This study evaluated the effectiveness of three common colonoscopy preparations: 2-dose magnesium citrate, 2-dose magnesium citrate plus polyethylene glycol (PEG) constipation, and PEG 3350 split. Data were collected from charts of diabetic adults (N=498) who had a screening colonoscopy at a Midwestern gastroenterology practice between January 2024 and November 2024. Patients who did not complete the preparation; take narcotic medications; or have a history of colon resection, colectomy, Crohn’s disease, or colitis were excluded. Data were analyzed using SPSS version 29, p<0.05. Per one-way between groups ANOVA, BBPS were significantly higher in PEG split preparation group (n=166, m=8.30±1.479) compared to the 2-does magnesium citrate preparation (n=166, m=7.84±1.869) and the PEG constipation preparation (n=166, M=7.77±1.910) groups. Per descriptive statistics, 42.37% (n=211) were taking GLP-1 receptor agonists and/or SGLT2 inhibitors. Removing patients who did not hold their GLP-1 or SGLT-2 medications, BBPS were still significantly higher in the PEG split preparation group (n=152, m=8.41±1.363) than in the PEG constipation preparation group (n=134. M=7.86±1.9132).  Diabetic adults without a history of kidney disease or heart failure should be prescribed the PEG 3350 split dose preparation unless they cannot tolerate a large volume preparation.