S702 The Impact of Glycemic Control on the Quality of Bowel Preparation in Patients Undergoing Elective Colonoscopy: A Retrospective Multi-Center Study
Notice bibliographique
Résumé
Introduction: Diabetes Mellitus (DM) can slow intestinal transit and delay gastric emptying potentially affecting the quality of bowel preparation (QBP) for colonoscopy. Suboptimal bowel preparation (BP) may lead to missed neoplastic or preneoplastic lesions. This study evaluates glycemic control’s impact on QBP in patients undergoing elective colonoscopy. Methods: A retrospective review of patients who underwent elective colonoscopy with HbA1c levels within one year of the procedure across eight hospitals was conducted. QBP was categorized as optimal or suboptimal based on the Boston Bowel Preparation and Ottawa Bowel Preparation Scales. The association between glycemic control, defined as Hba1c < 5.7 or FBS < 100 mg/dL (Non-diabetic); Hba1c: 5.7-6.4% or FBS: 100-125 mg/dL (Pre-diabetes); Hba1c: 6.5-9.5% or FBS: 126 mg/dL-225 mg/dL (Well-controlled diabetes); Hba1c: >9.5% or FBS >225 mg/dL (Poorly controlled diabetes), and QBP was investigated, along with other patient demographic and clinical characteristics. Socioeconomic status was decided based on the insurance coverage carried by the patient. Significance was assessed at P< 0.05. Results: A total of 1458 patients were included in the analysis (Table 1). QBP was suboptimal in 98 (6.7%) patients. Average days between HbA1c or FBS and colonoscopy were 119.4±89.2. Overall, optimal QBP rates were higher in poorly controlled diabetics (79.5% vs 20.5%, P< 0.001) compared to suboptimal QBP. However, non-diabetics (6.9%), pre-diabetics (4.8%) and well-controlled diabetics (7.7%), had lower rates of suboptimal QBP as compared to poorly controlled diabetics (20.5%). Patients from low socioeconomic status had higher rates of optimal QBP (90.7% vs 9.3%, P< 0.001) but higher rates of suboptimal QBP compared to high socioeconomic status patients (4.7%). Additionally, diabetics on insulin had higher rates of optimal QBP (78.1% vs 21.9%, P< 0.001) but higher rates of suboptimal QBP compared to non-insulin dependent diabetics (5.5%). There were no statistical differences in the QBP rates for age, gender, BMI and patients on GLP-1 agonists. Conclusion: This study shows that poorly controlled and insulin-dependent diabetics have higher rates of suboptimal QBP, leading to missed lesions and increased colon cancer risk. Limited access to healthcare due to low socioeconomic status indirectly contributes to poorly controlled DM and higher rates of suboptimal QBP. Identifying poor preparation risks allows targeted interventions to enhance QBP in high-risk patients. Table 1. - Patient Characteristics and Comparative Analysis of Optimal and Suboptimal Bowel Preparation Groups Patient Characteristics Overall Optimal Bowel Prep Quality Suboptimal Bowel Prep Quality 'P' Value Age (Mean±SD) in years 59.9±9.6 59.96±9.51 58.45±10.25 0.132 Sex Female Male 54.8%45.2% 94.1%92.3% 5.9%7.7% 0.159 Socioeconomic Status Low High 44.2%55.8% 90.7%95.3% 9.3%4.7% < 0.001 BMI (n=1407) Underweight (< 18.5) Healthy Weight (18.5-24.9) Overweight (25-29.9) Obese ( >30) 0.4%15.3%31.9%52.4% 100%94.4%93.3%92.7% 0%5.6%6.7%7.3% 0.736 Glycemic Control Non-diabetic Pre-diabetes Well Controlled Diabetes Poorly Controlled Diabetes 39.5%35.7%22.2%2.7% 93.1%95.2%92.3%79.5% 6.9%4.8%7.7%20.5% < 0.001 Insulin Yes No 7.2%92.8% 78.1%94.5% 21.9%5.5% < 0.001 GLP1 Agonist Yes No 4.5%95.5% 89.2%93.5% 7.1%6.5% 0.198 BMI: Body Mass Index, FBS: Fasting Blood Glucose, GLP-1: Glucagon Like Peptide 1.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».