S702 The Impact of Glycemic Control on the Quality of Bowel Preparation in Patients Undergoing Elective Colonoscopy: A Retrospective Multi-Center Study
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".