Safety of Fasting in Patients with Type 1 Diabetes during Ramadan: A Prospective Study from Pakistan

Muhammad Shoaib Ahmedani, S. F. D. Alvi, Prof. Dr. Asher. Fawwad, M. Ulhaque, Sanober Naz, A. Basit
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引用次数: 2

Abstract

Aims: To observe safety of fasting in patients with type 1 diabetes during Ramadan. Methods: A prospective, case control study was conducted in the Out-patient department of Baqai Institute of Diabetology and Endocrinology from June to September 2013. The study was carried out in two phases; Pre-Ramadan recruitment phase (Visit A) and Post-Ramadan follow-up phase (Visit B) of the same patients. In visit A, Ramadan-specific diabetes education was delivered by health care providers in group session and educational material provided to each patient. Results: Sixty two patients with type 1 diabetes (42 in fasting and 20 in non-fasting group) participated in the study. No significant change (p > 0.05) observed in weight and HbA1c of fasting and non-fasting groups before and after Ramadan. During Ramadan, out of 1380 blood glucose readings in fasting group, there were 98 (7.1%) and 570 (41.3%) episodes of hypoglycemia and hyperglycemia respectively. None of the patients developed diabetic ketoacidosis and none required hospitalization. No significant difference (p > 0.05) observed in the frequency of hypoglycemia while hyperglycemia increased (p < 0.05) when glycemic status during Ramadan was compared with Pre-Ramadan. No significant difference (p > 0.05) observed in the frequency of hypoglycemia and hyperglycemia when Ramadan was compared with Post-Ramadan. Conclusion: We observed that majority of patients with type 1 diabetes did not have serious acute complications of diabetes during Ramadan. Safety of fasting can be ensured in patients with type 1 diabetes with Ramadan-specific diabetes education and medical supervision.
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斋月期间1型糖尿病患者禁食的安全性:来自巴基斯坦的一项前瞻性研究
目的:观察1型糖尿病患者斋月期间禁食的安全性。方法:采用2013年6 - 9月在巴卡医院糖尿病与内分泌研究所门诊进行前瞻性病例对照研究。这项研究分两个阶段进行;同一患者的斋月前招募阶段(访问A)和斋月后随访阶段(访问B)。在访问A中,卫生保健提供者在小组会议中提供了针对斋月的糖尿病教育,并向每位患者提供了教育材料。结果:62例1型糖尿病患者(禁食组42例,非禁食组20例)参与了研究。斋月前后禁食组和非禁食组体重、糖化血红蛋白均无显著变化(p > 0.05)。斋月期间,禁食组的1380个血糖读数中,分别有98个(7.1%)和570个(41.3%)低血糖和高血糖发作。无患者发生糖尿病酮症酸中毒,无患者需要住院治疗。斋月期间血糖状态与斋月前相比,低血糖发生频率无显著差异(p > 0.05),高血糖发生频率增高(p < 0.05)。斋月期间与斋月后低血糖、高血糖发生频率比较,差异均无统计学意义(p > 0.05)。结论:我们观察到大多数1型糖尿病患者在斋月期间没有严重的急性糖尿病并发症。1型糖尿病患者斋月特异性糖尿病教育和医学监督可确保禁食的安全性。
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