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Positive stress test, diabetic, BP issues. Stop diabetes medication?

I am going for a Cardio Angio as stress test was positive. I am diabetic and recently being treated for BP. Doctor has asked me to have light breakfast and stop diabetic medicines.Can you please explain why. Thanks. Ashok Kumar
Asked On : Mon, 18 Feb 2013
Answers:  2 Views:  52
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General & Family Physician 's  Response
A cardio Angiography requires a dye or a contrast medium to be injected .
Contrast medium can be damaging to the kidneys. Usually, this damage is temporary and corrects itself quickly. However, because the kidneys remove metformin, contrast medium can greatly increase the level of metformin in the blood because damaged kidneys are not as effective at removing metformin from the body. High levels of metformin in the blood increase the risk of lactic acidosis .Because lactic acidosis is so dangerous, metformin should be temporarily stopped for procedures involving contrast medium.

To avoid you from developing lactic acidosis,your doctor has asked to stop taking oral anti diabetics.These are generally stopped 48 hours prior to the test and not given for another 48 hours after the test.
Answered: Wed, 20 Feb 2013
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Internal Medicine Specialist Dr. Akhilesh Dubey's  Response
Welcome to HCM,
I appreciate your concern about your health,you are diabetic and Hypertensive and stress test is positive and it is good that you are undergoing angiography.
Now to answer your question anti diabetic drugs are stopped before angiography iodinated contrast media (ICM),increases levels of metformin by decreasing renal clearance. Lactic acidosis may occur.
Due to this we stop 48 hours prior to procedure and 48 hours after the procedure.
Please follow instruction from your doctor do not worry it is done as precaution.
Take care
Good Luck.

Answered: Wed, 20 Feb 2013
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