Introduction Diabetic patients (DM) often have numerous co-mobidities and can suffer from autonomic dysfunction and poor GI motility. It is unknown whether their outcomes are any worse within the Bowel Cancer Screening Programme (BCSP) than Non-Diabetic patients (NDM)
Methods An audit was performed in 2011 on 100 consecutive Diabetic (DM) and Non-Diabetic (NDM) patients that had received Moviprep as an oral cleansing agent (50 each group); in order to evaluate the quality colonoscopy outcomes within the Merseyside & North Cheshire BCSP.
Results The mean age was 67.96 in DM and 67.44 in NDM groups. There were more males in the DM group (78% v 54%). Median ASA in both groups was 2. The bowel preparation was poor in 14% of DM which led repeat colonoscopy in 7 patients. In the NDM poor bowel preparation was in 8% with 4 repeat colonoscopies. The caecal intubation rate (CIR) was 92% in each group but in the DM group the reason for failure was poor prep, whilst in the NDM is was acute angulation and sigmoid looping. i.e. not poor bowel preparation. The adenoma detection rate (ADR) was 62% with an mean of 2.1 polyps per colonoscopy in DM compared to ADR of 52% and mean 1.4 per colonoscopy in NDM. There was 1 cancer detected in each group. Neither group had any complications and no readmissions or 30 day mortality.
Conclusion Our findings were 3 fold. 1) Outcomes of Diabetic (DM) & Non Diabetic (NDM) patients were similar for CIR, Cancers detected & Adverse Events. 2) Bowel preparation is below QA &GRS standards in DM patients which consequently led to significant number of repeat procedures and to failure to complete the colonoscopy in all of group of patients. 3) ADR and numbers found per colonoscopy seem to be greater in DM even with the poorer bowel prep. This may reflect the male preponderance but needs further investigation. We are looking at changing the bowel preparation from Moviprep to Kleen prep in the diabetic population within our programme.
Disclosure of Interest None Declared.
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