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Diabetes medicines and peri-procedural blood glucose management
Case scenarioDavid, 68, presents to the pharmacy 7 days before a scheduled colonoscopy. He says the written instructions from the clinic were ‘hard to follow’ and asks whether he should stop ‘all his tablets’. David has type 2 diabetes, hypertension and atrial fibrillation. He uses a weekly dose administration aid (DAA) prepared by the pharmacy. His regular medicines include apixaban, ramipril, empagliflozin, metformin and atorvastatin. He also takes ibuprofen intermittently for knee pain and a garlic supplement. He has been advised to fast and complete bowel preparation the day before the procedure and is unsure which medicines to continue, stop or restart. |
Introduction
Australians make 440 million visits to their pharmacist each year,1 with community pharmacists frequently consulted by patients preparing for diagnostic or minor surgical procedures. These encounters often occur when instructions are unclear, leaving patients unsure which medicines to stop, when to stop them, and how to safely resume therapy. Temporary medicine changes can be particularly confusing for patients using dose administration aids (DAAs), increasing the risk of dosing errors or procedural delays.
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