Analysis Of Factors Infiuencing The Quality Of Bowel Preparation Related To Diabetic Patients

Objective:To investigate the effects of different bowel preparation protocols on bowel cleanliness in type 2 diabetic patients,and to provide an in-depth analysis of the relevant factors affecting the quality of bowel preparation in type 2 diabetic patients,so as to provide a basis for developing individualized bowel preparation for type 2 diabetic patients.Methods:339 patients with type 2 diabetes mellitus who underwent colonoscopy in the gastroscopy room of Qinhuangdao First Hospital from October 2020 to April 2022 were collected by questionnaire survey,and the enrolled patients were randomly divided into 2 groups according to the order of consultation(patients with single number into group A,patients with double number into group B),174 in group A and 165 in group B.Different times and different doses of oral compound polyethylene glycol(PEG)were used.Electrolyte bulking regimen(Group A:1L PEG orally at20:00 pm the night before the examination and 2L PEG orally at 8:00 am the morning of the examination;Group B:1L PEG orally starting at 8:00am the morning of the examination,followed by 200 ml every 15 minutes until finished),all patients enrolled in the group were given 30 ml of simethicone oil emulsion and dissolved in the last 1L PEG liquid to be taken before the operation,and The time interval between the last dose of laxative and the end of colonoscopy was 4-6 hours in all patients.General information(age,sex,height,weight,history of smoking,history of alcohol consumption,fasting blood glucose level,duration of diabetes,place of bowel preparation,whether previous colonoscopy was performed,history of previous abdominal surgery,history of previous constipation,whether walking exercise was performed after taking the drug,number of bowel movements after taking the drug,patient’s education level,etc.)was also collected,and the bowel cleansing effect,adverse effects and tolerance of patients were recorded,and the The Boston Bowel Scale was used to evaluate the amount of fecal water in the patient’s intestine and the clarity of the visual field and other indicators.The general information of patients collected in the questionnaire was subjected to multifactorial Logisitic regression analysis to obtain the factors affecting the effect of bowel preparation in type 2 diabetic patients.Results:A total of 339 patients with type 2 diabetes were enrolled in this study,and the failure rate of intestinal preparation was 23.6%.Group A(81%)was superior to Group B(72%)in the qualification rate of intestinal preparation,but there was no significant difference in adverse reactions and tolerance between the two groups(P>0.05);In univariate analysis,the unqualified factors for intestinal preparation were age(P<0.001,X~2=18.386),BMI(P=0.025,X~2=7.407),history of constipation(P=0.004,X~2=8.223),intestinal preparation site(P=0.014,X~2=6.090),history of abdominal surgery(P=0.029,X~2=4.783),walking after medication(P=0.009,X~2=6.772),and intestinal preparation protocol(P=0.039,X~2=4.257),fasting plasma glucose level(P<0.001,X~2=6.429);In multivariate analysis,the factors leading to unqualified bowel preparation were age≥60 years(OR=3.453,95%CI=1.790-6.664),constipation(OR=2.537,95%CI=1.323-4.863),fasting plasma glucose between 6.1mmol/L～7.8 mmol/L(OR=2.547,95%CI=1.293-5.018),and fasting plasma glucose between 7.8 mmol/L～10 mmol/L(OR=12.228,95%CI=5.359-27.902).Conclusion:1.Split-dose and divided-dose administration of compounded polyethylene glycol electrolyte bulk has the potential to improve the quality of bowel preparation in patients with type 2 diabetes mellitus.2.Fasting plasma glucose level,history of constipation,and age may be independent risk factors for substandard bowel preparation in type2 diabetic patients,and identification of these factors is beneficial for improving the quality,test tolerance,and effectiveness of bowel preparation in type 2 diabetic patients.