Diabetes and Ramadan: Practical guidelines 2021

Hassanein, Mohamed; Afandi, Bachar; Ahmedani, Muhammad Yakoob; Alamoudi, Reem; Alawadi, Fatheya; Bajaj, Harpreet S.; Basit, Abdul; Bennakhi, Abdullah; Sayed, Adel A. El; Hamdy, Osama; Hanif, Wasim; Jabbar, Abdul; Kleinebreil, Line; Lessan, Nader; Shaltout, Inass; Bebakar, Wan Mohamad Wan; Abdelgadir, Elamin; Abdo, Sarah; Al-Ozairi, Ebaa; Saleh, Yousef Al; Alarouj, Monira; Ali, Tomader; Al-Madani, Abdulrazzaq; Assaad-Khalil, S.; Bashier, Alaaeldin; Beshyah, Salem A; Büyükbeşe, Mehmet Akif; Chowdhury, Tahseen A; Diop, S; Elbarbary, Nancy; Elhadd, Tarik; Eliana, Fatimah; Faris, MoezAlIslam; Hafidh, Khadija; Hussein, Zanariah; Iraqi, H.; Kaplan, Walid; Khan, Talat; Khunti, Kamlesh; Maher, Salma; Malek, R.; Malik, Rayaz A.; Mohamed, Mafauzy; Mohamed, Mesbah Sayed Kamel; Mohamed, Nazeer Ahmed; Pathan, Sameer A.; Rashid, Fouzia; Sahay, Rakesh; Salih, Bashir; Sandid, Mohamad A.; Shaikh, Shehla; Slim, I.; Tayeb, Khaled; Yusof, Barakatun-Nisak Mohd; Zainudin, Sueziani Binte

doi:10.1016/j.diabres.2021.109185

Cited by 94 publications

(119 citation statements)

References 96 publications

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“…Design: A before-after intervention study was done. Risk evaluation of patients before Ramadan according to IDF-DAR 2021 risk categories [2] was estimated. IDF-DAR 2021 risk categories were shown in supplementary figure 1.…”

Section: Methodsmentioning

confidence: 99%

“…International diabetes federation-Diabetes and Ramadan (IDF-DAR) 2021 established guidelines for doctors to categorize patients who intend to fast during Ramadan based on status of glycemic control, hypoglycemia risk, glycemic lowering medications, diabetes related complications and comorbidities. Individuals in the moderate and high risk categories for developing complications related to fasting should be advised against fasting [2].…”

Section: Introductionmentioning

confidence: 99%

“…Elderly people have higher rates of diabetes-related complications and co-morbidities, longer duration of disease and risk for frailty and cognitive impairment. These factors place most elderly patients in the high risk category for fasting and development of complications during Ramadan [2]. Ramadan fasting in 2021 occurred during COVID 19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

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Positive impact of pre-Ramadan education on glycemic control and reducing risk of hypoglycemia in type 2 diabetic elderly patients during COVID 19 pandemic

Toony

Elghazally

Hamad

2022

Primary Care Diabetes

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Positive impact of pre-Ramadan education on glycemic control and reducing risk of hypoglycemia in type 2 diabetic elderly patients during COVID 19 pandemic

Toony

Elghazally

Hamad

2022

Primary Care Diabetes

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“…The number of patients with diabetes has increased to 537 million, even worse, diabetes is spiraling out of control. International Diabetes Federation estimated that there will be more than 780 million patients with diabetes in 2045 [ 1 ]. Diabetes can cause damage to heart, brain, kidney, peripheral nerve, retina, and other important target organs.…”

Section: Introductionmentioning

confidence: 99%

Glucose fluctuation promotes cardiomyocyte apoptosis by triggering endoplasmic reticulum (ER) stress signaling pathway in vivo and in vitro

Liu

et al. 2022

Bioengineered

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Glucose fluctuation is more harmful than sustained hyperglycemia, but the effect on cardiomyocyte apoptosis have not yet been clarified. In this study, we aim to identify the effect of glucose fluctuation on cardiomyocyte apoptosis and explore the underlying mechanism. Sprague-Dawley rats were intraperitoneally injected with streptozotocin (STZ) and divided into three groups: controlled diabetic group (C-STZ); uncontrolled diabetic group (U-STZ) and glucose fluctuated diabetic group (GF-STZ). After twelve weeks, echocardiography, Hematoxylin-eosin (HE) staining, and Masson staining were adopted to assess the cardiac function and pathological changes. TUNEL staining was used to detect apoptotic cells. Expressions of apoptosis-related proteins and key molecules in the endoplasmic reticulum (ER) stress pathway were determined via western blots. Further, primary cardiomyocytes incubated in different glucose conditions were treated with the inhibitor of ER stress to explore the causative role of ER stress in glucose fluctuation-induced cardiomyocyte apoptosis. In vivo , we demonstrated that glucose fluctuation promoted cardiomyocyte apoptosis, and were more harmful to cardiomyocytes than sustained hyperglycemia. Moreover, glucose fluctuation significantly triggered ER stress signaling pathway. In vitro , primary cardiomyocyte apoptosis induced by glucose fluctuation and the activation of ER stress were significantly attenuated by 4-PBA, which is an ER stress inhibitor. Above all, glucose fluctuation can promote cardiomyocyte apoptosis through triggering the ER stress signaling pathway in diabetic rats and in primary cardiomyocytes.

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“…Although the Diabetes and Ramadan International Alliance (DaR) and the International Diabetes Federation (IDF) collaboratively published practice guidelines ( 5 , 12 ), healthcare providers continue to have knowledge gaps pertaining to diabetes management during Ramadan. Beshyah et al conducted a survey on 260 physicians from 27 countries—almost all Muslim majority countries.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of Insulin Management Recommendations to Improve Glycemic Control and Reduce Hypoglycemic Events During Ramadan Fasting in Patients With Insulin-Requiring Type 2 Diabetes

et al. 2022

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BackgroundMuslims with insulin-requiring type 2 diabetes are at high risk of hypo- and hyperglycemia while fasting during the month of Ramadan. Although a few reviews on diabetic management during Ramadan have been published, surveys reveal knowledge gaps remain among physicians.AimThis systematic review qualitatively analyzes what insulin dosing recommendations are likely to reduce hypoglycemic events and improve glycemic control during the Ramadan fasting for this high-risk group.MethodsA comprehensive search in six databases and gray sources was performed from August 10, 2001, to August 10, 2021, for studies assessing which types of insulin and/or what dosing recommendations reduce hypoglycemic events and improve glycemic control during Ramadan. We excluded studies focusing mainly on oral antihyperglycemic medications, type 1 diabetes, persons with insulin pumps, and studies older than 20 years. Hypoglycemic event rates, pre-, and post-iftar blood glucose levels, overall average blood glucose, and hemoglobin A1c were analyzed, and a narrative synthesis was performed.ResultsOut of 1,101 collected articles, 14 eligible studies including 2,969 participants with an average age of 54.8 years, we found that insulin dose reduction may prevent hypoglycemia without causing subsequent hyperglycemia, and rapid-acting insulin analogs may improve post-iftar and overall blood glucose without incurring hypoglycemia.ConclusionsThough initial findings are promising, more research is needed to confirm the benefits of insulin dose reduction, rapid-acting insulin analogs, and ultra-long-acting insulins.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42021268943.

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Diabetes and Ramadan: Practical guidelines 2021

Cited by 94 publications

References 96 publications

Positive impact of pre-Ramadan education on glycemic control and reducing risk of hypoglycemia in type 2 diabetic elderly patients during COVID 19 pandemic

Positive impact of pre-Ramadan education on glycemic control and reducing risk of hypoglycemia in type 2 diabetic elderly patients during COVID 19 pandemic

Glucose fluctuation promotes cardiomyocyte apoptosis by triggering endoplasmic reticulum (ER) stress signaling pathway in vivo and in vitro

A Systematic Review of Insulin Management Recommendations to Improve Glycemic Control and Reduce Hypoglycemic Events During Ramadan Fasting in Patients With Insulin-Requiring Type 2 Diabetes

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