Muslims with non-insulin dependent diabetes fasting during Ramadan: treatment with glibenclamide.

Belkhadir, Jamal; Ghomari, H. El; Klöcker, Nikolaj; Mikou, A; Nasciri, M; Sabri, M

doi:10.1136/bmj.307.6899.292

Cited by 94 publications

(69 citation statements)

References 8 publications

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“…In keeping with this, a large epidemiological study conducted in 13 Islamic countries on 12,243 individuals with diabetes who fasted during Ramadan showed a high rate of acute complications (4). However, a few studies on this topic using relatively small groups of patients suggest that complication rates may not be significantly increased (7)(8)(9)(10)(11). In Table 1, we outline some of the major potential complications associated with fasting in patients with diabetes and briefly discuss them below.…”

Section: Risks Associated With Fasting In Patients With Diabetes -Fasmentioning

confidence: 99%

“…However, there is no information linking repeated yearly episodes of short-term hyperglycemia (e.g., 4-week duration) and diabetesrelated complications. Control of glycemia in patients with diabetes who fasted during Ramadan has been reported to deteriorate, improve, or show no change (7)(8)(9)(10)(11). The extensive EPIDIAR study showed a fivefold increase in the incidence of severe hyperglycemia (requiring hospitalization) during Ramadan in patients with type 2 diabetes (from 1 to 5 events ⅐ 100 people Ϫ1 ⅐ month Ϫ1 ) and an approximate threefold increase in the incidence of severe hyperglycemia with or without ketoacidosis in patients with type 1 diabetes (from 5 to 17 events ⅐ 100 people Ϫ1 ⅐ month Ϫ1 ) (4).…”

Section: Hyperglycemiamentioning

confidence: 99%

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Recommendations for Management of Diabetes During Ramadan

Alarouj

Bouguerra

Buse³

et al. 2005

Diabetes Care

234

231

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Section: Risks Associated With Fasting In Patients With Diabetes -Fasmentioning

confidence: 99%

Section: Hyperglycemiamentioning

confidence: 99%

Recommendations for Management of Diabetes During Ramadan

Alarouj

Bouguerra

Buse³

et al. 2005

Diabetes Care

234

231

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“…There have been many reports on metabolic changes during and after Ramadan in healthy subjects (Frost & Pirani, 1987;Husain et al, 1987;Finch et al, 1998;Adlouni et al, 1997Adlouni et al, , 1998Maislos et al, 1993Maislos et al, , 1998el Ati et al, 1995) and in patients with diabetes (Laajam, 1990;Mafauzy et al, 1990;Belkhadir et al, 1993). In diabetes, assessing such changes is particularly important, since the quantity, quality and timing of meals constitute a most important component of any diabetes management strategy.…”

Section: Introductionmentioning

confidence: 99%

Beneficial changes in serum apo A-1 and its ratio to apo B and HDL in stable hyperlipidaemic subjects after Ramadan fasting in Kuwait

2000

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Background: In patients with metabolic and nutritional disorders such as diabetes and hyperlipidaemia, where strict compliance to advice on timing and composition of food intake is important, the prolonged daylight fasting during the month of Ramadan could produce undesirable biochemical consequences. Aim: The study aimed to compare pre-and post-Ramadan lipid and lipoprotein pro®les in stable Kuwaiti hyperlipidaemic subjects attending a Lipid Clinic. Subjects and methods: The study population comprised 64 adult Kuwaitis (33 M, 31 F) who had been attending a Lipid Clinic for at least 12 months and were considered stable, without any acute systemic illness. At each clinic visit, the following parameters were measured: weight, total cholesterol (TC), triglycerides (TG), HDL, LDL, apo A-1, apo B, glucose and uric acid. These biochemical parameters were measured by routine automated analyzer techniques. The pre-Ramadan values comprised the means of two measurements taken at about 3 month and 1 month before commencement of Ramadan. Post-Ramadan values were obtained within 1 month of the end of the Ramadan fast. The parameters so obtained were compared in the whole group, and then according to gender, glycaemic status and modality of treatment (diet alone or with a ®brate or statin). Results and discussion: In the nondiabetic subjects, apo A-1 and apo A-1aapo B and apo A-1aHDL ratios were increased post-Ramadan (P`0.001). Weight did not change and the other lipid parameters Ð TC, TG, LDL, apo B Ð did not worsen. These observations, more consistent in the men than in the women, and in subjects treated with a ®brate or a statin rather than on diet alone, indicate a favorable coronary heart disease (CHD) risk pro®le. In the diabetic patients, these changes in the apo A-1 level and its ratio to HDL and apo B were also present, but TC and apo B levels increased, the latter signi®cantly (P`0.05). These divergent effects in diabetic patients could variably in¯uence CHD risk liability. Serum uric acid levels were also simultaneously reduced postRamadan in the non-diabetic subjects and those on statin treatment. Conclusion: When pre-and post-Ramadan lipid and lipoprotein pro®les were compared in stable hyperlipidaemic subjects attending a Lipid Clinic in Kuwait, the most consistent changes post-Ramadan were increased levels of apo A-1 and apo A-1aapo B and apo A-1aHDL ratios and reduced uric acid levels. Body weight remained essentially unchanged and the other lipoprotein and lipid parameters were not worsened. These results suggest that Ramadan fasting in hyperlipidaemic subjects might favorably in¯uence CHD risk.

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“…However, there have been only a few studies that examined the effect of the fast on basic homeostatic functions. [1][2][3] There have been several animal studies that have shown that hypertension can be caused or exacerbated by cycles of fasting and refeeding. [4][5][6][7] Initially, during the fast, there is a reduction in blood pressure.…”

Section: Introductionmentioning

confidence: 99%

The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives

et al. 2001

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Every year, millions of Moslems throughout the world fast from sunrise till sunset daily during the month of Ramadan, that is, experience repeated cycles of fastingrefeeding. Studies in animal models have shown that repeated cycles of fasting-refeeding may cause or exacerbate hypertension. Changes in sleeping patterns as well as changes in medication timing may also influence ambulatory blood pressure. We undertook this study in order to examine the effect of the Ramadan fast on treated hypertensive subjects. Seventeen hypertensive subjects were examined, and 24-h blood pressure monitoring was carried out twice, before and during the last week of the Ramadan. All continued their medications, which were all once-daily preparations. Twenty-

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Muslims with non-insulin dependent diabetes fasting during Ramadan: treatment with glibenclamide.

Cited by 94 publications

References 8 publications

Recommendations for Management of Diabetes During Ramadan

Recommendations for Management of Diabetes During Ramadan

Beneficial changes in serum apo A-1 and its ratio to apo B and HDL in stable hyperlipidaemic subjects after Ramadan fasting in Kuwait

The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives

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