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Diabetes

Adjusting your diabetes medicine and diet for a hydrogen breath test for small intestine bacterial overgrowth

​​​This test is used to find out if you have too much bacteria (overgrowth) in your small intestine. You’ll have to drink liquid that has 75g of glucose for the test.

Follow the instructions your gasterenterology (GI) Clinic gives you about when and what to eat and drink before the test.

If you see a diabetes educator or diabetes specialist, contact them at least 1 week before your test to ask about adjusting your diabetes medicine or insulin.

Testing your blood sugar

Test your blood sugar anytime you feel your blood sugar is low or high.

  • Test your blood sugar at least every 4 hours. Blood sugars in the range of 8.0 to 12.0 mmol/L are fine for this test, even if it’s higher than your usual target.
  • If you have type 1 diabetes or you are on an SGLT2 inhibitor canagliflozin (Invokana), dapagliflozin (Forxiga), empagliflozin (Jardiance) and ertugliflozin (Steglatro) and your sugars are over 14.0 mmol/L, test your urine or blood for ketones.
    • If you have Type 1 diabetes and positive for ketones, you may need extra insulin. Moderate to large ketones may mean that you’re in DKA (diabetic ketoacidosis) and need to go to the Emergency Department right away.​
  • If you’re worried about your blood sugar level, speak with your healthcare provider or diabetes educator.

Adjusting your diabetes medicine

If you take insulin

The day​ before your test
  • All doses stay the same for breakfast, lunch and supper.

Evening/Bedtime

  • Basal Insulin: Reduce your dose of basal insulin (Humulin N, Novolin NPH, Lantus, Basaglar, Toujeo, Levemir or Tresiba) by 20% or the amount your healthcare provider tells you. Tresiba may need to be reduced for 2-3 days before the procedure. Talk with your healthcare provider.
    Your dose will be units.
  • Insulin Pump: You may need to reduce your basal rate by 10% to 20% overnight if there are concerns about low blood sugar. If there are no concerns, keep the same basal rate.
Test day

Morning

  • Bolus (meal) Insulin: Don’t take your morning bolus (meal) insulin (Apidra, Humalog, NovoRapid, Fiasp Humulin R, or Novolin Toronto).
  • Premix Insulin: Don’t take your morning pre-mix insulin (Humulin 30/70, Novolin 30/70, or Humalog 25/75).
  • Basal Insulin: Reduce your dose of basal insulin (Humulin N, Novolin NPH, Lantus, Basaglar, Toujeo, Levemir or Tresiba) by 20% or the amount your healthcare provider tells you. Tresiba may need to be reduced for 2-3 days before the procedure. Talk with your healthcare provider.
    Your dose will be units.
  • Insulin Pump: You may need to reduce your basal rate by 10% to 20% if there are concerns about low blood sugar. If there are no concerns, keep the same basal rate.

*Be sure to bring a source of fast-acting sugar and your blood glucose meter with you.

During the test

*You’ll be given a 75 g glucose/water solution to drink.*

  • Bolus: Reduce your dose of meal (bolus) insulin (Apidra, Humalog, NovoRapid, Fiasp, Humulin R, or Novolin Toronto) by 20% or the amount your healthcare provider tells you, and take it before you drink the solution. Your dose will be units.​
  • Premix Insulin: Reduce your dose of morning premix insulin (Humulin 30/70, Novolin 30/70, or Humalog 25/75​) by 20% (or the amount your healthcare provider tells you) and take it before​ you drink the solution. Your dose will be units.

After the test

  • Take your diabetes medicine as per your next scheduled dose.

If you take diabetes ​medicine other than insulin

The day before your test
  • Take your diabetes medicine as usual or as your healthcare provider tells you.
Test day
  • Don’t take any diabetes medicine until after your test is done and you're eating. Then take it as per your scheduled dose.

*Be sure to bring a source of fast-acting sugar and your blood glucose meter with you.​

For 24/7 nurse advice and general health information call Health Link at 8​11.

Current as of: July 10, 2020

Author: Endocrinology and Metabolism Program, Alberta Health Services