RESUMEN
Physiological impact of the intermittent or prolonged fasting is known from various studies on healthy subjects. However, data on impact of fasting on biochemical and biometric parameters in people with diabetes is building up. Safety of Ramadan fasting has always been assessed after Ramadan. This study looked into the immediate effect of fasting during the fasting days compared to time before and after the fasting month. METHODS: This is an observational study. We looked into people with biometric and biochemical records before Ramadan, and we followed them up during and after Ramadan prospectively. We were aiming for assessing the biochemical and biometric changes for people with diabetes during Ramadan in comparison to pre-and post Ramadan. As well as the differences between these measures according to type and treatment of diabetes in those who fasted as well as in those who did not fast during Ramadan. RESULTS: Total of 342 patients were recruited to the study. All were patients with diabetes at a mild to moderate risk of complications if fasted. Majority were males 52.3% (n = 180), while females were 47.7% (n = 162). Most of the results showed a U shape between Pre-Ramadan, During Ramadan and Post-Ramadan periods. there was a modest but significant reduction in weight but regained after Ramadan. CONCLUSIONS: Our study suggests that for many people with diabetes fasting is not associated with an increased risk to their glycemic control, their weight and/or their blood pressure. Indeed, what is seen is marginal benefit or no change in all parameters. This stratifies the ongoing recommendation that allows patients with categorized as low risk to fast Ramadan or non-Ramadan days whenever desired.
Asunto(s)
Biometría/métodos , Diabetes Mellitus Tipo 2/sangre , Ayuno/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Islamismo , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto JovenRESUMEN
BACKGROUND: Physiology of intermittent and prolonged fasting is known from healthy subjects. Evidence on high and very high-risk groups is lacking. The anticipated risks include hypoglycemia, hyperglycemia, dehydration and thrombosis. Education, pre-Ramadan doses adjustment, and glucose monitoring devices (Optimum diabetes care in Ramadan) is expected to lower this risk. AIMS: We aimed to assess the value of optimum care in diabetes management during Ramadan on the metabolic parameters of high risk patients with diabetes. Moreover, we wanted to assess and understand the safety of fasting in this group. METHODS: This is a prospective interventional study. Patient with high-risk diabetes who insisted on fasting. High risk patients defined as any one with type 1 or type 2 diabetes on insulin, Gestational diabetes, stage 3 kidney disease, and having history of ischemic heart disease. All patients received a Freestyle Libre continuous glucose monitoring device, and was offered to attend the clinic at any time during the study, this collectively defined as optimum diabetes care during Ramadan. Biometric (Weight, height, Blood pressure) and biochemical (Glycosylated hemoglobin A, Lipids profile, creatinine, and estimated glomerular filtration rate) were reported within 4-6â¯weeks before and after Ramadan. RESULTS: Total of 169 patients were. Majority were females 54.4% (nâ¯=â¯92). There was a remarkable improvement in glycemic control from 7.6â¯+â¯1.2 to 7.3â¯+â¯1.2 percent (pâ¯=â¯0.00). Serum creatinine showed a negligible change at the end of the study from 0.81â¯+â¯0.3 to 0.82â¯+â¯0.2â¯mg/dl). Only total cholesterol worsened significantly (pâ¯=â¯0.02).