Practical Management of Diabetes during Ramadan Fast

Beshyah, Salem A.; Benbarka, Mahmoud M; Sherif, Ibrahim H.

doi:10.3402/ljm.v2i4.4731

Cited by 30 publications

(47 citation statements)

References 7 publications

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“…However, current evidence has proved that with proper education, appropriate adjustment of the drug regimen, diet control and daily activity, it is safe for adult diabetics with type 1 and type 2 to fast during Ramadan. [278910111213] Regimens using short acting insulin before meals with a long-acting insulin in the evening have been safely used in adults. [7] Our study in T1DM showed that most of children with conventional insulin regimen could complete the fast.…”

Section: Discussionmentioning

confidence: 99%

Fasting during Ramadan in adolescents with diabetes

Zabeen

Tayyeb

Benarjee

et al. 2014

Indian J Endocr Metab

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Background:Fasting (Sawm) during Ramadan, one of the five pillars of Islam is obligatory for all healthy adult and adolescent Muslims from the age of 12 years. Some children with diabetes, despite their exemption insist on fasting in Ramadan. We evaluated the safety of fasting among children with type 1 diabetes.Materials and Mathods:A prospective observational study was designed for diabetic children and adolescents who wish to fast during Ramadan 2012. Patients with their caregivers were given intensive education and instructions were provided by diabetic educators, dieticians and physicians on insulin adjustment, home blood glucose monitoring and dietary adjustments prior to Ramadan.Results:A total of 33 children and adolescents were included in this study. Of these, 16 were male and 17 were female. Majority (60.6%) of the patients could complete their fasting during the Ramadan. Patients were divided into two groups, those who completed fasting were considered as Group-I, whereas patients who broke the fast were in Group-ll. Blood glucose, hemoglobin A1c weight, and insulin dose before and after Ramadan in two groups showed no significant difference.Conclusion:Children older than 11 years of age with type 1 diabetes mellitus with conventional twice-a-day regimen can fast safely during Ramadan provided they have proper education and intensive follow-up during Ramadan.

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Section: Discussionmentioning

confidence: 99%

Fasting during Ramadan in adolescents with diabetes

Zabeen

Tayyeb

Benarjee

et al. 2014

Indian J Endocr Metab

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“…While the prevalence of hypoglycemia and hyperglycemia has been reported in 4% and 8%, respectively, only 23% of patients with diabetes practice glucose monitoring during the fasting period 40. One study reported that 18% of patients experience one or more episodes of hypoglycemia during the Ramadan period; however, most patients with hypoglycemia did not break their fast 33. Of interest, there does not appear to be a significant difference in the total number of calories consumed during the Ramadan period, and it is not clear if there is a significant difference in glucose control during the fasting period 40.…”

Section: Additional Regional Peculiaritiesmentioning

confidence: 99%

Recommendations for management of diabetes during Ramadan: update 2015

Ibrahim¹,

Magd

Annabi

et al. 2015

BMJ Open Diab Res Care

122

125

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Since the first ADA working group report on the recommendations for management of diabetes during Ramadan in 2005 and our update in 2010, we received many inquiries asking for regular updates on information regarding education, nutritional habits and new oral and injectable agents that may be useful for the management of patients with diabetes during Ramadan. Patients can be stratified into their risk of hypoglycemia and/or complications prior to the start of the fasting period of Ramadan. Those at high risk of hypoglycemia and with multiple diabetic complications should be advised against prolonged fasting. Even in the lower hypoglycemia risk group, adverse effects may still occur. In order to minimize adverse side effects during fasting in patients with diabetes and improve or maintain glucose control, education and discussion of glucose monitoring and treatment regimens should occur several weeks prior to Ramadan. Agents such as metformin, thiazolidinediones and dipeptidyl peptidase-4 inhibitors appear to be safe and do not need dose adjustment. Most sulfonylureas may not be used safely during Ramadan except with extreme caution; besides, older agents, such as chlorpropamide or glyburide, should not be used. Reduction of the dosage of sulfonylurea is needed depending on the degree of control prior to fasting. Misconceptions and local habits should be addressed and dealt with in any educational intervention and therapeutic planning with patients with diabetes. In this regard, efforts are still needed for controlled prospective studies in the field of efficacy and safety of the different interventions during the Ramadan Fast.

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“…Exemptions are permitted for individuals who are ill, pregnant, travelling or present an overall weakness that could lead to complications when fasting 2 , 3 . Even so, many choose to fulfil their religious duty and continue to fast during this month despite discouragement from doctors and treatment guidelines 4 – 6 .…”

Section: Introductionmentioning

confidence: 99%

Telemonitoring in fasting individuals with Type 2 Diabetes Mellitus during Ramadan: A prospective, randomised controlled study

Lee

Wong

Tan

et al. 2017

Sci Rep

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We determined the impact of a remote blood glucose telemonitoring program with feedback in type 2 diabetes mellitus patients fasting during Ramadan compared to conventional self-monitoring method. A twelve-week cluster randomised study, with 85 participants who wish to fast for at least 15 days during Ramadan was conducted. Self-measurement and transmission of blood glucose results were performed six times daily during Ramadan. Results were transmitted to a secure website for review with feedback from case manager if necessary. The control group received usual care. The main outcome was the number of participants experiencing hypoglycaemia during Ramadan and at the end of the study. During Ramadan, the number of participants reporting hypoglycaemia was significantly lower in the telemonitoring group [Odds ratio (OR): 0.186, 95% confidence interval: 0.04–0.936; p = 0.04]. Similarly, the proportion of participants reporting symptomatic hypoglycaemia at the end of the study was significantly lower in the telemonitoring group (OR: 0.257, 95% CI: 0.07–0.89; p = 0.03). A reduction of 1.07% in glycated haemoglobin levels was observed in the telemonitoring group compared to 0.24% in the control group (p < 0.01). Overall, telemonitoring was a useful adjunct to reduce the risk of hypoglycaemia during Ramadan with no deterioration in glycaemic control

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Practical Management of Diabetes during Ramadan Fast

Cited by 30 publications

References 7 publications

Fasting during Ramadan in adolescents with diabetes

Fasting during Ramadan in adolescents with diabetes

Recommendations for management of diabetes during Ramadan: update 2015

Telemonitoring in fasting individuals with Type 2 Diabetes Mellitus during Ramadan: A prospective, randomised controlled study

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