The impact of the Yom Kippur fast on emergency room visits among people with diabetes

Becker, Maier; Karpati, Tomas; Valinsky, Liora; Heymann, Anthony

doi:10.1016/j.diabres.2012.10.005

Cited by 11 publications

(8 citation statements)

References 5 publications

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“…17 Fortunately, given the wealth of information and studies from other countries, there is a foundation to create quality improvement projects focused on education, knowledge, and awareness of both health providers and patients regarding diabetes management during Ramadan in the United States. Future studies should attempt to understand the role of culture, behavior, and the environment for developing such interventions in the United States, and how that may be different from other countries.…”

Section: Discussionmentioning

confidence: 99%

Primary Care Providers’ Knowledge and Practices of Diabetes Management During Ramadan

Ali

Adams

Hossain

et al. 2015

J Prim Care Community Health

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There are an estimated 3.5 million Muslims in North America. During the holy month of Ramadan, healthy adult Muslims are to fast from predawn to after sunset. While there are exemptions for older and sick adults, many adults with diabetes fast during Ramadan. However, there are risks associated with fasting and specific management considerations for patients with diabetes. We evaluated provider practices and knowledge regarding the management of patients with diabetes who fast during Ramadan. A 15-question quality improvement survey based on a literature review and the American Diabetes Association guidelines was developed and offered to providers at the outpatient primary care and geriatric clinics at an inner-city hospital in New York City. Forty-five providers completed the survey. Most respondents did not ask their Muslim patients with diabetes if they were fasting during the previous Ramadan. Knowledge of fasting practices during Ramadan was variable, and most felt uncomfortable managing patients with diabetes during Ramadan. There is room for improvement in educating providers about specific cultural and medical issues regarding fasting for patients with diabetes during Ramadan.

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Section: Discussionmentioning

confidence: 99%

Primary Care Providers’ Knowledge and Practices of Diabetes Management During Ramadan

Ali

Adams

Hossain

et al. 2015

J Prim Care Community Health

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“…Typically, in the process of losing fat mass through a calorie restricted diet, patients can experience a decrease in fat-free or lean mass that contributes to 20-35% of the total weight lost, depending on baseline weight [123]. However, a meta-analysis of ten TRE intervention studies with 241 participants showed no change in fat-free/lean mass (−0.24 kg, 95% CI, −1.15 to 0.67) without significant heterogeneity among the results of the included studies [41].…”

Section: Tre Safetymentioning

confidence: 99%

“…However, these findings may differ when TRE is performed for longer duration, especially if it results in clinically significant weight loss. In longer duration TRE interventions or in patient populations with baseline low lean mass or frailty, concurrent prescription of regular physical activity (especially resistance exercise training) and high protein intake (1.25-1.50 times the recommended dietary allowance) are recommended to help to reduce the concomitant loss of lean mass [123].…”

Section: Tre Safetymentioning

confidence: 99%

Time-Restricted Eating: A Novel and Simple Dietary Intervention for Primary and Secondary Prevention of Breast Cancer and Cardiovascular Disease

Christensen

Kirkham

2021

Nutrients

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There is substantial overlap in risk factors for the pathogenesis and progression of breast cancer (BC) and cardiovascular disease (CVD), including obesity, metabolic disturbances, and chronic inflammation. These unifying features remain prevalent after a BC diagnosis and are exacerbated by BC treatment, resulting in elevated CVD risk among survivors. Thus, therapies that target these risk factors or mechanisms are likely to be effective for the prevention or progression of both conditions. In this narrative review, we propose time-restricted eating (TRE) as a simple lifestyle therapy to address many upstream causative factors associated with both BC and CVD. TRE is simple dietary strategy that typically involves the consumption of ad libitum energy intake within 8 h, followed by a 16-h fast. We describe the feasibility and safety of TRE and the available evidence for the impact of TRE on metabolic, cardiovascular, and cancer-specific health benefits. We also highlight potential solutions for overcoming barriers to adoption and adherence and areas requiring future research. In composite, we make the case for the use of TRE as a novel, safe, and feasible intervention for primary and secondary BC prevention, as well as tertiary prevention as it relates to CVD in BC survivors.

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“…A study conducted to assess the frequency of ER visits 48 hours before and 48 hours after Yom Kippur showed no difference in visits frequency in 3441 orthodox fasting patients with diabetes. There was also no demonstrated increase in frequency between orthodox fasting Jewish and secular patients with diabetes 141 . According to Grajower and Zangen, patients with T1DM with inadequate control (ie, blood glucose > 250 mg/dL), physical trauma, sign of infection or fever should not be permitted to fast 142 …”

Section: Hypoglycaemia In Particular Situationsmentioning

confidence: 99%

Hypoglycaemia and its management in primary care setting

Ibrahim¹,

Baker

Cahn³

et al. 2020

Diabetes Metabolism Res

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Hypoglycaemia is common in patients with type 1 diabetes and type 2 diabetes and constitutes a major limiting factor in achieving glycaemic control among people with diabetes. While hypoglycaemia is defined as a blood glucose level under 70 mg/dL (3.9 mmol/L), symptoms may occur at higher blood glucose levels in individuals with poor glycaemic control. Severe hypoglycaemia is defined as an episode requiring the assistance of another person to actively administer carbohydrate, glucagon, or take other corrective actions to assure neurologic recovery. Hypoglycaemia is the most important safety outcome in clinical studies of glucose lowering agents. The American Diabetes Association Standards of Medical Care recommends that a management protocol for hypoglycaemia should be designed and implemented by every hospital, along with a clear prevention and treatment plan. A tailored approach, using clinical and pathophysiologic disease stratification, can help individualize glycaemic goals and promote new therapies to improve quality of life of patients. Data from recent large clinical trials reported low risk of hypoglycaemic events with the use of newer anti‐diabetic drugs. Increased hypoglycaemia risk is observed with the use of insulin and/or sulphonylureas. Vulnerable patients with T2D at dual risk of severe hypoglycaemia and cardiovascular outcomes show features of “frailty.” Many of such patients may be better treated by the use of GLP‐1 receptor agonists or SGLT2 inhibitors rather than insulin. Continuous glucose monitoring (CGM) should be considered for all individuals with increased risk for hypoglycaemia, impaired hypoglycaemia awareness, frequent nocturnal hypoglycaemia and with history of severe hypoglycaemia. Patients with impaired awareness of hypoglycaemia benefit from real‐time CGM. The diabetes educator is an invaluable resource and can devote the time needed to thoroughly educate the individual to reduce the risk of hypoglycaemia and integrate the information within the entire construct of diabetes self‐management. Conversations about hypoglycaemia facilitated by a healthcare professional may reduce the burden and fear of hypoglycaemia among patients with diabetes and their family members. Optimizing insulin doses and carbohydrate intake, in addition to a short warm up before or after the physical activity sessions may help avoiding hypoglycaemia. Several therapeutic considerations are important to reduce hypoglycaemia risk during pregnancy including administration of rapid‐acting insulin analogues rather than human insulin, pre‐conception initiation of insulin analogues, and immediate postpartum insulin dose reduction.

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The impact of the Yom Kippur fast on emergency room visits among people with diabetes

Cited by 11 publications

References 5 publications

Primary Care Providers’ Knowledge and Practices of Diabetes Management During Ramadan

Primary Care Providers’ Knowledge and Practices of Diabetes Management During Ramadan

Time-Restricted Eating: A Novel and Simple Dietary Intervention for Primary and Secondary Prevention of Breast Cancer and Cardiovascular Disease

Hypoglycaemia and its management in primary care setting

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