MANAGING HYPERGLYCEMIA IN ONCOLOGY PATIENTS SCHEDULED FOR FDG-PET/CT
If the patient is diabetic, in addition to the preparation instructions and diet, carefully monitor and check the blood sugar for at least 3 days before the examination.
An effort should be made to achieve glycemic values < 200mg/dL before the FDG PET/CT examination.
The doctor should provide the consultation regarding the medication, especially if taking antidiabetic drugs containing metformin or are on insulin therapy.
Contact the physician in charge of the PET/CT department at phone number +357 22053555, who will inform you about the exact preparation you will need for the examination.
Recommendations:
Type II Diabetes Mellitus (controlled with oral medication):
Patients must comply with the fasting rules mentioned above.
Patients continue to take oral medications to control their blood sugar.
Discontinuation of metformin for 2 days before the study if there are gastrointestinal tumors (to minimize unintentional gastrointestinal uptake) or if there was apparent gastrointestinal uptake in previous PET studies.
Type I Diabetes Mellitus and insulin-dependent Type II Diabetes Mellitus:
There are three options for scheduling the FDG PET/CT study:
1.For patients receiving subcutaneous rapid or short-acting insulin injection, the examination can be scheduled for late morning or noon.
The patient should eat breakfast early in the morning (around 7:00 a.m.) and inject the regular amount of insulin. Subsequently, the patient should not consume any other food or liquids, except for the prescribed amount of water.
2.For patients receiving subcutaneous intermediate-acting insulin (Humulin N, Novolin N) or long-acting insulin (Levemir, Lantus, Semglee, and Tresiba) administered the previous evening, the examination can be scheduled for early morning. The patient should eat a normal breakfast after the PET/CT study and inject the regular amount of insulin.
3.For patients receiving continuous insulin infusion
FDG PET/CT should be scheduled early in the morning. The insulin pump should be turned off at least 4 hours before FDG administration. The patient can have breakfast after the FDG PET/CT study and resume continuous insulin infusion.
*The above recommendations for managing hyperglycemia in oncology patients scheduled for FDG-PET/CT examination are in accordance with the guidelines from the Society of Nuclear Medicine and Molecular Imaging (SNMMI) as well as those of the European Association of Nuclear Medicine and Molecular Imaging (EANMMI)
If the patient is diabetic, in addition to the preparation instructions and diet, carefully monitor and check the blood sugar for at least 3 days before the examination.
An effort should be made to achieve glycemic values < 200mg/dL before the FDG PET/CT examination.
The doctor should provide the consultation regarding the medication, especially if taking antidiabetic drugs containing metformin or are on insulin therapy.
Contact the physician in charge of the PET/CT department at phone number +357 22053555, who will inform you about the exact preparation you will need for the examination.
Recommendations:
Type II Diabetes Mellitus (controlled with oral medication):
Patients must comply with the fasting rules mentioned above.
Patients continue to take oral medications to control their blood sugar.
Discontinuation of metformin for 2 days before the study if there are gastrointestinal tumors (to minimize unintentional gastrointestinal uptake) or if there was apparent gastrointestinal uptake in previous PET studies.
Type I Diabetes Mellitus and insulin-dependent Type II Diabetes Mellitus:
There are three options for scheduling the FDG PET/CT study:
1.For patients receiving subcutaneous rapid or short-acting insulin injection, the examination can be scheduled for late morning or noon.
The patient should eat breakfast early in the morning (around 7:00 a.m.) and inject the regular amount of insulin. Subsequently, the patient should not consume any other food or liquids, except for the prescribed amount of water.
- FDG administration should be injected no earlier than 4 hours after subcutaneous rapid-acting insulin injection (Humalog, Novolog, and Apidra) or
- 6 hours after subcutaneous short-acting insulin injection (Actrapid Humulin Regular).
- FDG administration is not recommended on the same day after intermediate and/or long-acting insulin injection.
2.For patients receiving subcutaneous intermediate-acting insulin (Humulin N, Novolin N) or long-acting insulin (Levemir, Lantus, Semglee, and Tresiba) administered the previous evening, the examination can be scheduled for early morning. The patient should eat a normal breakfast after the PET/CT study and inject the regular amount of insulin.
3.For patients receiving continuous insulin infusion
FDG PET/CT should be scheduled early in the morning. The insulin pump should be turned off at least 4 hours before FDG administration. The patient can have breakfast after the FDG PET/CT study and resume continuous insulin infusion.
*The above recommendations for managing hyperglycemia in oncology patients scheduled for FDG-PET/CT examination are in accordance with the guidelines from the Society of Nuclear Medicine and Molecular Imaging (SNMMI) as well as those of the European Association of Nuclear Medicine and Molecular Imaging (EANMMI)
