Management of Diabetes Medications Before Colonoscopy

Medication-Specific Recommendations

The American Gastroenterological Association recommends holding Jardiance on the day of the procedure, while Januvia can be continued, Lantus should be reduced but not completely discontinued, and Glipizide should be held on the day of the procedure to minimize hypoglycemia risk 1, 2
Hold Jardiance on the morning of colonoscopy to avoid potential dehydration and electrolyte imbalances during bowel preparation 3
Resume Jardiance after the procedure once normal eating has resumed and kidney function has been verified 3
Januvia can be safely continued through the colonoscopy preparation period 2
Unlike GLP-1 receptor agonists, DPP-4 inhibitors do not significantly delay gastric emptying and do not increase risk of inadequate bowel preparation 1

For medications that need to be held, stop them on the morning of the colonoscopy 3
For split-dose bowel preparation regimens, begin the second portion 4-6 hours before colonoscopy and complete at least 2 hours before the procedure 3
Monitor blood glucose more frequently during the preparation period, especially during the fasting phase 3

Check kidney function before restarting SGLT-2 inhibitors like Jardiance, especially in high-risk patients 3
Resume normal medication schedule once eating has resumed after the procedure 3
Restarting SGLT-2 inhibitors without verifying kidney function can increase risk of complications 3