Diabetes-specific bowel preparation: evidence synthesis on risk factors and multimodal interventions

Background Diabetic patients exhibit significantly higher rates of inadequate bowel preparation (IBP) during colonoscopy compared to non-diabetic populations, primarily due to hyperglycemia-induced gastrointestinal dysmotility, laxative restrictions from renal impairment, polypharmacy interactions, and suboptimal behavioral compliance. Objective This review synthesises evidence on risk factors and evidence-based interventions for IBP in diabetic patients, aiming to establish optimized preparation protocols for this high-risk cohort. Conclusion Multimodal strategies integrating chronotherapy, nutritional optimisation, and AI-driven decision support significantly enhance bowel preparation quality while stabilising glycemic control. Future research should prioritise standardised diabetes-specific protocols validated through multicenter trials.