Scribd Logo
Upload

Welcome to Scribd!

  • 18 views

    Contrast Media Diabetes

    Uploaded by

    Kovacs Aliz
    This document provides recommendations for the use of iodinated contrast agents in diabetic patients. There are three main concerns for diabetic patients undergoing contrast imaging: fasting can cause hypoglycemia, renal failure can be worsened by contrast agents, and metformin use increases the risk of lactic acidosis if renal failure occurs after contrast administration. The document provides guidance on pre-imaging testing, hydration, discontinuing or adjusting diabetic medications, and monitoring based on a patient's specific situation and medications.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Contrast Media Diabetes

    Uploaded by

    Kovacs Aliz
    18 views2 pages
    This document provides recommendations for the use of iodinated contrast agents in diabetic patients. There are three main concerns for diabetic patients undergoing contrast imaging: fasting can cause hypoglycemia, renal failure can be worsened by contrast agents, and metformin use increases the risk of lactic acidosis if renal failure occurs after contrast administration. The document provides guidance on pre-imaging testing, hydration, discontinuing or adjusting diabetic medications, and monitoring based on a patient's specific situation and medications.

    Original Title

    CONTRAST MEDIA DIABETES

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document provides recommendations for the use of iodinated contrast agents in diabetic patients. There are three main concerns for diabetic patients undergoing contrast imaging: fasting can cause hypoglycemia, renal failure can be worsened by contrast agents, and metformin use increases the risk of lactic acidosis if renal failure occurs after contrast administration. The document provides guidance on pre-imaging testing, hydration, discontinuing or adjusting diabetic medications, and monitoring based on a patient's specific situation and medications.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    18 views2 pages

    Contrast Media Diabetes

    Uploaded by

    Kovacs Aliz
    This document provides recommendations for the use of iodinated contrast agents in diabetic patients. There are three main concerns for diabetic patients undergoing contrast imaging: fasting can cause hypoglycemia, renal failure can be worsened by contrast agents, and metformin use increases the risk of lactic acidosis if renal failure occurs after contrast administration. The document provides guidance on pre-imaging testing, hydration, discontinuing or adjusting diabetic medications, and monitoring based on a patient's specific situation and medications.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    RECOMMENDATION FOR THE USE OF CONTRAST MEDIA

    IODINATED CONTRAST
    AGENTS AND DIABETES

    PRESENTATION
    There is 3 problems with the diabetic patient: fasting, renal failure, and ongoing
    medication (insulin, oral antidiabetic, metformin).
     fasting can cause hypoglycaemic accidents.
     Renal failure can be worsened by the injection of a contrast agent.
     Metformin exposes to the risk of lactic acidosis by diminution of renal clea-
    rance in case of ICM induced nephropathy.

    GENERAL ADVICE
     Have at hand a recent serum creatinine level test (less than 3 months old in the
    absence of intercurrent events).
     Use low osmolality agents.
     Keep the patient hydrated:
     orally = 2 litres of sodium rich water in the 24 hours preceding and follo-

    wing contrast medium injection.


     parenterally: 100ml per hour of saline isotonic serum or bicarbonated

    isotonic serum in the 12 hours to and after the injection of ICM.

    PATIENTS ON INSULIN
     Insulin therapy should not be discontinued. Fasting should be avoided.
    However, in cases where it is recommended, put on a perfusion of glucose until
    the fast is broken, and do the examination as early as possible. Fasting should not
    exceed 6 hours.

    Version 2 - Avril 2005


    1
    CIRTACI - RECOMMENDATION FOR THE USE OF CONTRAST MEDIA
    IODINATED CONTRAST AGENTS AND DIABETES

    PATIENTS ON DERIVATIVES OF METFORMIN


     Meftformin is the most common of oral antidiabetic drugs. The active princi-
    ple is not metabolized and is eliminated via the kidneys. Elimination is complete
    in 48 hours. Metformin is contraindicated in cases of renal insufficiency.
    Accumulation of the drug can induce lactic acidosis when contrast medium
    induced renal failure happens (in the 48 hours following the injection).
     The therapy should be discontinued for 48 hours from the time of iodinated
    contrast medium administration. Stopping it 48 hours before the examination is
    not advised anymore. The therapy is resumed once the renal function has been
    checked.

    PATIENTS ON ORAL ANTIDIABETICS


    (OTHER THAN METFORMIN)

     The treatment is continued.


     In case of renal failure, refer to the specific advice on the prevention of renal
    failure.

    REFERENCES
    1. Metformin and contrast media - a dangerous combination? McCartney MM, Gilbert FJ, Murchison
    LE, Pearson D, McHardy K, Murray AD. Clin Radiol 1999;54:29-33
    2. Guidelines for performing angiography in patients taking metformin, Heupler FA. Catheterization
    and cardiovascular diagnosis 1998;43:121-3
    3. Clinical risk associated with contrast angiography in metformin treated patients: a clinical review.
    Nawaz S, Cleveland T, Gaines PA, Chan P. Clin Radiol 1998;53:342-4
    4. Metformin and contrast media: where is the conflict? Rasuli P, Hammond DI. Can Assoc Radiol J
    1998;49:161-6
    5. Approach to the patient with diabetes undergoing a vascular or interventional procedure.
    Hirsch IB. J Vasc Interv Radiol. 1997 May-Jun;8(3):329-36.
    6. Metformin and contrast media: genuine risk or witch hunt? Pond GD, Smyth SH, Roach DJ,
    Hunter G. Radiology 1996;201:879-80M

    Comité Interdisciplinaire de Recherche et de Société Française de Radiologie


    Travail sur les Agents de Contraste en Imagerie

    Version 2 - Avril 2005


    2

    You might also like