P4111 - Improving Bowel Preparation Quality in Diabetics: The Double Dose Preparation Initiative

Binyamin R. Abramowitz, MD¹, Benjamin Silver, MD², Promila Banerjee, MD, FACG³, Daniel A. DiLeo, MD⁴, Bani Chander-Roland, MD, FACG^5
1SUNY Downstate Health Sciences University, New York, NY; ²SUNY Downstate Medical Center, Brooklyn, NY; ³Edward Hines Jr. Veterans Affairs Hospital, Loyola University Chicago Stritch School of Medicine, Maywood, IL; ⁴Brooklyn VA Medical Center, Brooklyn, NY; ⁵VA NY Harbor Health System Clinical Associate Professor SUNY Downstate Health Sciences University, Brooklyn, NY

Introduction: Bowel preparation quality is essential for diagnostic accuracy during colonoscopy. To optimize bowel preparation in patients undergoing colonoscopies at the New York Harbor Brooklyn VA Hospital, patients deemed to be of higher risk for poor preparation were given two doses of MoviPrep prior to their procedures starting in July of 2021. The selection criteria included patients above age 65, a BMI over 25, bed-bound patients, diabetics, those with a history of stroke, Parkinson’s disease, or chronic constipation, and those using constipation-inducing medications. The purpose of our study was to evaluate as to whether the double prep initiative helped to improve bowel preparation quality in diabetic patients.

Methods: We performed a retrospective chart review at the Brooklyn VA Hospital. Patients who fit the selection criteria for double dose preparation that underwent colonoscopy between April and June of 2021 comprised the pre-initiative cohort. Patients who fit the selection criteria that underwent colonoscopy between October 2023 and February 2024 comprised the post-initiative cohort. Demographic and clinical information was collected and analyzed. Patients were sub-stratified into three groups; those with diabetes, those with prediabetes, and those without either (non-diabetics). Bowel preparation quality was evaluated using the Boston Bowel Prep Score (BBPS).

Results: 448 patients were included in our study; 245 patients in the pre-initiative cohort and 203 patients in the post-initiative cohort. Although no significant differences between the two cohorts were found in bowel preparation quality in non-diabetics, prediabetics were more likely to have poor bowel preparation (BBPS below 6) in the pre-initiative cohort. Additionally, diabetics were significantly more likely to have ideal bowel preparation (BPPS of 8-9) in the post-initiative cohort.

Discussion: As prediabetics were noted to be less likely to have poor bowel preparation and diabetics were more likely to have ideal bowel preparation with two doses of MoviPrep instead of one dose, our data strongly supports the double dose initiative in diabetic as well as prediabetic patients. Widespread adoption of the double dose initiative can help to improve diagnostic accuracy, increase procedural efficiency, and reduce the number of unnecessary procedures done on patients. Further studies are needed to provide support for the double dose initiative for the non-diabetic patients that fit the selection criteria mentioned above.


Disclosures:


Binyamin R. Abramowitz, MD¹, Benjamin Silver, MD², Promila Banerjee, MD, FACG³, Daniel A. DiLeo, MD⁴, Bani Chander-Roland, MD, FACG⁵. P4111 - Improving Bowel Preparation Quality in Diabetics: The Double Dose Preparation Initiative, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.