Recommendations for Management of Diabetes During Ramadan

Alarouj, Monira; Assaad-Khalil, S.; Buse, John B.; Fahdil, Ibtihal; Fahmy, M. A. H.; Hafez, Sherif; Hassanein, Mohamed; Ibrahim, Mahmoud; Kendall, David M.; Kishawi, Suhail; Al-Madani, Abdulrazzaq; Nakhi, Abdullah Ben; Tayeb, Khaled; Thomas, Abraham

doi:10.2337/dc10-0896

Cited by 357 publications

(486 citation statements)

References 38 publications

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“…For subjects randomized to sulphonylurea, more subjects in the glibenclamide/glyburide stratum experienced ADA‐classified hypoglycaemic episodes than those in the glimepiride/gliclazide/glipizide stratum, as previously reported 5, 29. Glibenclamide/glyburide may be associated with a higher risk of hypoglycaemia than other second‐generation sulphonylureas, specifically gliclazide, glimepiride and glipizide 29, 30.…”

Section: Discussionsupporting

confidence: 57%

Efficacy and safety of liraglutide compared to sulphonylurea during Ramadan in patients with type 2 diabetes (LIRA‐Ramadan): a randomized trial

Azar

Echtay

Bebakar

et al. 2016

Diabetes Obesity Metabolism

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AimsCompare effects of liraglutide 1.8 mg and sulphonylurea, both combined with metformin, on glycaemic control in patients with type 2 diabetes (T2D) fasting during Ramadan.Materials and methodsIn this up to 33‐week, open‐label, active‐controlled, parallel‐group trial, adults [glycated haemoglobin (HbA1c) 7%‐10% (53‐86 mmol/mol); body mass index ≥20 kg/m2; intent to fast] were randomized (1:1) ≥10 weeks before Ramadan to either switch to once‐daily liraglutide (final dose 1.8 mg) or continue pre‐trial sulphonylurea at maximum tolerated dose, both with metformin. Primary endpoint: change in fructosamine, a validated marker of short‐term glycaemic control, during Ramadan.ResultsSimilar reductions in fructosamine levels were observed for both groups during Ramadan [liraglutide (−12.8 µmol/L); sulphonylurea (−16.4 µmol/L); estimated treatment difference (ETD) 3.51 µmol/L (95% CI: −5.26; 12.28); p = 0.43], despite lower fructosamine levels in the liraglutide group at start of Ramadan. Fewer documented symptomatic hypoglycaemic episodes were reported in liraglutide‐treated (2%, three subjects) versus sulphonylurea‐treated patients (11%, 18 subjects). No severe hypoglycaemic episodes were reported by either group. Body weight decreased more during Ramadan with liraglutide (ETD: −0.54 kg; 95% CI: −0.94;−0.14; p = 0.0091). The proportion of patients reporting adverse events was similar between groups. Liraglutide led to greater HbA1c reduction [ETD: −0.59% (−6.40 mmol/mol), 95% CI: −0.79; −0.38%; −8.63; −4.17 mmol/mol; p < 0.0001].ConclusionsDespite lower fructosamine levels and body weight at the beginning of Ramadan, use of liraglutide showed similar glycaemic improvements, fewer hypoglycaemic episodes and greater body weight reduction compared with sulphonylurea. LIRA‐Ramadan provides evidence for liraglutide being safe and efficacious for management of T2D during Ramadan fasting.

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Section: Discussionsupporting

confidence: 57%

Efficacy and safety of liraglutide compared to sulphonylurea during Ramadan in patients with type 2 diabetes (LIRA‐Ramadan): a randomized trial

Azar

Echtay

Bebakar

et al. 2016

Diabetes Obesity Metabolism

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“…La disidratazione può associarsi a ipercoagulabilità e trombosi. [6] dell'autocontrollo finalizzati a minimizzare i rischi del digiuno [5].…”

Section: Disidratazioneunclassified

“…La riduzione dell'introito di cibo è una causa nota di ipoglicemia [6,7]. Nei pazienti con diabete di tipo 1 è causa di morte nel 2-4% dei casi [8].…”

Section: Ipoglicemiaunclassified

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Diabetes and Ramadan: need for a cultural action

Visalli¹,

Casucci

Cipolloni³

et al. 2014

CMI

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29no è più importante il significato spirituale di quello materiale: l'uomo obbedisce a un ordine divino, impara a tenere sotto controllo i suoi desideri fisici e supera la sua natura umana. Si abitua alla moderazione: abbandonarsi senza freni anche a bisogni leciti, come il cibo e i rapporti sessuali, rende l'uomo schiavo di abitudini e voglie.Nel digiuno, il ricco prova le ristrettezze che il povero ha quotidianamente e tutta la comunità vive una comunione di spirito che aumenta il senso di fratellanza, di pazienza e di disciplina fra i musulmani. Tutti i musulmani che abitano l' emisfero nord e quello sud hanno la possibilità, nel corso della loro esistenza, di digiunare in stagioni diverse, perché i mesi lunari sono alternativamente di 29 e 30 giorni e l'anno lunare in tutto è di 354 giorni, undici giorni in meno rispetto a quello solare. Il Ramadan cade così in diverse stagioni. In certi Paesi, durante l'inverno, le giornate sono corte e fredde e il digiuno di Ramadan è certamente meno impegnativo da rispettare che nella stagione estiva. In tutto questo, il credente intravede la saggezza, la giustizia e la misericordia di Dio. Il digiuno deve essere preceduto dalla niyyah (intenzione). Dopo la pronuncia dell'intenzione, si incomincia a digiunare, all'aurora.Il pasto iftar, consumato al tramonto, rappresenta il momento della rottura del digiuno. È caratterizzato da 3 portate. La prima è INTRODUZIONELa multietnia è una realtà in continua crescita. Le culture d' origine rivestono molta importanza nel condizionare le condotte, le richieste di cura e la disponibilità a determinate terapie. In Italia, il 33% dei cittadini non comunitari è di fede islamica, numero raddoppiato negli ultimi 10 anni [1].Le differenze religiose/culturali hanno un ruolo importante nella gestione del diabete; il digiuno per i musulmani durante il Ramadan rappresenta un caso emblematico, vero e proprio banco di prova in termini terapeutici e alimentari per gli operatori sanitari [2][3][4]. RAMADAN: INQUADRAMENTO CULTURALEIl mese di Ramadan è il nono del calendario islamico, è sacro all'Islàm perché è «il mese in cui fu rivelato il Corano come guida per gli uomini e prova chiara di retta direzione e salvezza» (Sura II, v. 185). Si tratta di un mese di purificazione, ricco di grazie, durante il quale, in una delle sue ultime notti dispari, la "notte del destino", le porte del cielo sono più dischiuse.Il Corano stabilisce l'obbligo del digiuno (Sura II, v. 183)

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“…Fasting in Ramadan is an obligatory Islamic ritual and is mandatory for all healthy Muslims men and women to fast between sunrises to sunset in this month, except those with religious exemptions [2]. The days and timing of this holy month is decided according to Islamic lunar calendar, which is eleven days shorter than solar calendar, so in every year timings of Ramadan is variable and come in different seasons in different countries.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study Comparing the Effects of Ramadan Fasting on Metabolic Parameters in Healthy Muslims from Three Different Nationalities in Dubai

Elamin¹

2015

J Diabetes Metab

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Objective: Many studies have evaluated the effect of Ramadan fasting on metabolic parameters. None of the previous studies compared the effect of fasting on people from different ethnic backgrounds. We conducted this prospective study to assess fasting Ramadan on Body Mass Index (BMI) and metabolic parameters in healthy volunteers from different ethnic backgrounds. Methodology:We studied the effect of fasting during Ramadan on body mass index, fasting lipid profile, blood glucose and HBA1c in 49 healthy Muslim volunteers. These individuals belong to three different ethnicities; Pakistanis, Sudanese and Emiratis. The blood samples and anthropometric measurements were taken on two occasions; one week before Ramadan and the second was collected with in two weeks after Ramadan.Results: There was a significant difference in body weight and BMI in all subjects of three nationalities at in of Ramadan fasting. There was no significant difference in fasting total cholesterol, triglyceride, HDL and LDL observed in Sudanese and Emiratis group, but subjects belong to Pakistani group showed statistically significant rise in total cholesterol by end of Ramadan. HDL has significantly reduced while total cholesterol has increased significantly in females compared to males. There were no reported hypoglycaemic events. Conclusion:Fasting Ramadan led to a statistically significant reduction in weight and BMI in all participants in same model of fasting. Total cholesterol has increased significantly in the Pakistani group compared to other population at the end of Ramadan. We observed a statistically significant increase in the HDL in females in comparison to males by the end of Fasting Ramadan.

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Recommendations for Management of Diabetes During Ramadan

Cited by 357 publications

References 38 publications

Efficacy and safety of liraglutide compared to sulphonylurea during Ramadan in patients with type 2 diabetes (LIRA‐Ramadan): a randomized trial

Efficacy and safety of liraglutide compared to sulphonylurea during Ramadan in patients with type 2 diabetes (LIRA‐Ramadan): a randomized trial

Diabetes and Ramadan: need for a cultural action

A Prospective Study Comparing the Effects of Ramadan Fasting on Metabolic Parameters in Healthy Muslims from Three Different Nationalities in Dubai

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