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Ramadan Fasting And Diabetes
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Book Synopsis Ramadan & Diabetes Care by : Abdul Hamid Zargar
Download or read book Ramadan & Diabetes Care written by Abdul Hamid Zargar and published by JP Medical Ltd. This book was released on 2013-10-31 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt: Fasting during the holy month of Ramadan is an important spiritual practice for many Muslims. This involves going without food, liquids and even medication between the hours of dawn until sunset, putting people with diabetes at significant risk of hypoglycaemia (low blood glucose), hyperglycaemia (high blood glucose), or dehydration. This book is a guide to the management of patients with diabetes during Ramadan. Beginning with an introduction to the physiology and endocrinology of fasting, the following chapters examine both pharmacological and non-pharmacological treatment options. The final sections are dedicated to management of the condition in different population groups (children, adolescents, the elderly); and management of complications, including hypoglycaemic and hyperglycaemic emergencies, and co-morbid conditions such as hypertension, high cholesterol and cardiovascular disease. Key points Guide to the management of diabetes during Ramadan Discusses both pharmacological and non-pharmacological treatment options Examines management of diabetes for different population groups Includes comprehensive section on complications and their management
Book Synopsis Impact of Optimum Diabetes Care on the Safety of Fasting in Ramadan in Adult Patients with Type 1 Diabetes Mellitus by : Al Saeed Maryam
Download or read book Impact of Optimum Diabetes Care on the Safety of Fasting in Ramadan in Adult Patients with Type 1 Diabetes Mellitus written by Al Saeed Maryam and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BackgroundIslamic law exempts patients with poor health from fasting duringRamadan. Some of our patients with type 1 diabetes are eager forRamadan fasting against medical advice and religious exemption.Current recommendations stratify this subgroup of patients as highrisk for fasting though the published data is sparsely available inthis regard.AimThe primary objective is to assess the safety of Ramadan fasting inpatients with type 1 diabetes by monitoring the rate and severity ofhypoglycemia and hyperglycemia during the fasting period and compareit with the non-fasting state.The secondary endpoint is to follow the effect of fasting on theirweight, blood pressure, and HbA1c by observing these parameters preand post Ramadan.MethodPatients with a known diagnosis of type 1 diabetes mellitus attendingthe Adult Endocrinology Clinic at Dubai Hospital were selected atconvenience 1-2 months before Ramadan, counselled, and asked to signan informed consent. Patients with concurrent renal disease or anyrecent hospitalisation in the last 3 months were excluded. All thepatients received a 90 minutes session for Ramadan-focused education.The Freestyle Libre flash sensor insertion was done for continuousglucose monitoring. Their biophysical and biochemical profile wascollected 2 to 4 weeks before and after Ramadan. We recorded diabetesrelated emergency visits or hospitalisation, change in BMI, systolicand diastolic BP, lipids profile, renal function, HBA1c, and frequencyof hypoglycemia during Ramadan fasting and non-fasting period.All the quantitative values are described as mean, and analysis of CGMdata is shown in frequencies.Results and DiscussionA total of 30 patients with type 1 diabetes were recruited, 4 patientsdropped out, 1 of which was due to a hospitalization with diabeticketoacidosis. 4 other patients did not complete the full protocol asthey only had one sensor. There were 26 patients in total with CGMdata available. 53% were male and 47% female with a mean age of 23.3yrs u00b17.85. The average duration of diabetes was 8.6 years. Themajority of patients were on basal bolus insulin with the exception of2 who were on an insulin pump. 21% reported fasting the entire monthof Ramadan with 24 days being the average number of days fasted.A total of 258 days of non-fasting data was recorded (47%) and 289days of fasting data in Ramadan (53%). 46.7% of patients had frequenthypoglycemic events of >10 episodes in 2 weeks during the non-fastingperiod compared to 29.2% who had a similar frequency of hypoglycemia(HE) during Ramadan. There was no difference between the percentage ofpatients who had 2-9 episodes of hypoglycemia with 50% of patients inboth groups. More patients had no HE recorded at all on CGM in theRamadan group (12.5%) compared to the non fasting period (8.3%). 79%of patients had a glucose reading below 49 mg/dl in the non-fastingperiod compared to 66.7% during Ramadan. The average duration of HEwas slightly longer during Ramadan with a mean of 98.50 minutes u00b162.55compared to 96.33 minutes u00b149.32 in the non-fasting period. Most HEoccurred between 00:00-06:00 (average 2.57 per/day) and the least HEoccurred between 06:00-12:00 (average 1.78 per/day) in the non-fastingperiod. During Ramadan, most HE occurred between 00:00-06:00 (average2.08 per/day) and the least events occurred between 12:00-18:00(average 1.29 per/day). 62% of patients improved in Ramadan by havingless HE, 9.5% remained the same, and 33.3% had more frequent HE duringRamadan. The mean average glucose around Iftar time was 181.1 mg/dlu00b158 and the mean glucose 2 hours later was 231.0 mg/dl u00b166.The average lab HbA1c pre Ramadan was 8.23% and 7.89% post Ramadan.Pre-Ramadan weight was 70.16 kg u00b1 17.92 and 69.61 kg u00b1 16.70post-Ramadan. Systolic blood pressure was 116.31 mmHg u00b1 15.45 beforeRamadan and 116.13 mmHg u00b1 12.25 post-Ramadan. Diastolic blood pressurewas 69.7 mmHg u00b1 7.46 before Ramadan and 66.31 mmHg u00b1 10.1post-Ramadan.ConclusionOptimum care for type 1 diabetes resulted in favorable glycemiccontrol after Ramadan fasting with less hypoglycemic episodes duringRamadan compared to non-fasting days. Biometric and biochemical dataremained the same, with a minor trend of improvement and there was anegligible hospitalization rate. Replication of the study in a largercohort is essential before clinical application.
Book Synopsis Ramadan Fasting and Diabetes by : Sharmin Hossain
Download or read book Ramadan Fasting and Diabetes written by Sharmin Hossain and published by LAP Lambert Academic Publishing. This book was released on 2012-03 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Effect of Ramadan fasting on certain anthropometric, clinical and biochemical parameters among type 2 diabetic subjects has been discussed in this book. Ninety two type 2 diabetic subjects (age 47 9 years, M SD) selected from a tertiary care hospital of the Diabetic Association of Bangladesh, was studied 1-4 weeks before and 3-4 weeks of Ramadan. There was no significant difference between before Ramadan and during Ramadan values of BMI and waist-to-hip ratio. However, during Ramadan fasting serum glucose, fructosamine, total cholesterol and creatinine were significantly higher compared to before Ramadan values (p>0.0001). Before Ramadan the duration of physical exercise was adequate in 30% subjects, but during Ramadan the corresponding value decreased to only 8% . Total energy expenditure of the subjects was significantly lower during Ramadan (2178.2 215.9) compared to before Ramadan value (2232.8 209.7, p>0.0001). The data suggest that Ramadan fasting is associated with a deterioration of metabolic control in diabetic patients. Coordinated education and motivation program should be undertaken to increase energy expenditure by physical activity.
Book Synopsis Impact of Ramadan Fasting on Glycemic Control in Type 2 Diabetic Patients Treated with Insulin by : Imen Sebai
Download or read book Impact of Ramadan Fasting on Glycemic Control in Type 2 Diabetic Patients Treated with Insulin written by Imen Sebai and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Impact of Ramadan fasting on glycemic control in type 2 diabetic patients treated with insulin.SEBAI I, MAHJOUB F, EL FELAH E, GAMMOUDI A, LAHMER I, BEN OTHMAN R, BERRICHE O, JAMOUSSI H.Service A, National Institute of Nutrition, Tunis, TUNISIABackground:Ramadan fasting, the fourth pillar of Islam, is a duty for all healthy Muslim adults. Quran exempts the sick from fasting. Nevertheless, some diabetic adults insist on observing Ramadan despite the potential risks incurred, the prohibition of doctors and the tolerance of religion. Aim: The aim of the study was to evaluate the effect of Ramadan fasting on glycemic control in type 2 diabetic patients treated with insulin.Methods:We performed a prospective study among type 2 diabetic patients at the National Institute of Nutrition in Tunisia. Patients were recruited one month before Ramadan 2015 which took place from 18 June to 16 July. Type 2 diabetic patients treated with insulin for more than three months, who had decided to fast Ramadan and who gave oral consent to participate in the study were included. Recruited patients were provided with glucometers, educated about diet and taught how to perform self-monitoring of blood glucose at home and when to break their fast. Insulin doses were altered according to the recommendations of the American Diabetes Association ADA 2010. All patients were instructed to call us for dose adjustment whenever necessary or if there was any episode of hypoglycemia. Glycosylated hemoglobin HbA1c was determined before and after Ramadan.Results:A total of 45 patients were included in the study (sex ratio (H/F) = 1,8; median age = 57,4 years(range 38-73 years), mean body mass index (BMI)= 28.56 kg/m2 u00b1 3,93 and mean duration of diabetes = 11,7 u00b1 6,6 years ). Type 2 diabetic patients were treated with insulin since a median of 3,9 years (range 4 monthes-23 years). Among them, 23 patients (51%) were categorized such as at high risk of hypoglycemia and 22 were stratified into the very high risk category. About 42% had chosen to fast without telling their doctors and 29% had insisted on fasting against the advice of their doctors. Half of our population (51%) had fasted Ramadan last year. This year, the average number of fasting days was 28,3 (range 20-29). We did not observe significant effect of Ramadan fasting on glycemic control. The mean hemoglobin A1c was 8,6% u00b1 1,46 before Ramadan and 8,4% u00b1 1,46 after Ramadan (p=0,142). During Ramadan, eight patients (18%) developed mild symptoms of hypoglycemia before Iftar. One patient hadnu2019t broken his fast. Four of them skipped fasting for subsequent 2-4 days. The majority (7/8) were treated with insulin analogs. No patient needed acute medical care or emergency hospitalization for diabetic ketoacidosis. Discussion:To the best of our knowledge, this is the first study to assess the merits of the ADA recommendations in the management of type 2 diabetic patients on insulin during Ramadan. In this study, we have observed that a significant number of patients insist on fasting. In addition, we noted that there was no significant effect of Ramadan on glycemic control. However fasting was associated with an increased risk of hypoglycemia despite the treatment adjustments and the use of insulin analogs. These results suggested that assisting individuals with type 2 diabetes who choose to fast is necessary before and during Ramadan to minimize the risk of afternoon hypoglycemia. The need of specific recommendations for Tunisian diabetic people cannot be overemphasized.
Book Synopsis Metabolic Perturbations in Type Two Diabetes During Ramadan Fasting by : Sandhya A. M
Download or read book Metabolic Perturbations in Type Two Diabetes During Ramadan Fasting written by Sandhya A. M and published by . This book was released on 2022-03-19 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction The burst out of Diabetes mellitus over the past 30 years has transformed the disease into a major cause of morbidity and mortality from the simple the tag of a mild disorder of elderly. In countries like India where major population belong to low- and middle-income group, the complete society is all the time more affected by the disease (Whiting et al., 2011). Diabetes mellitus is a chronic condition of multifactorial hyperglycemia with or without excretion of glucose through urine. This deadly disease is known to the mankind since pre-historic era. The etiologies for the rise in blood glucose range from autoimmune destruction of pancreatic beta cell to idiopathic. The key pathophysiology behind the hyperglycemia is the deficiency of insulin or defective response to insulin by tissues. The metabolic alterations in diabetes mellitus over years infuriate the functioning of various organs like heart, brain, kidney, retina, lens, vascular system, peripheral nerves and often compromise the quality and longevity of life (American Diabetes Association, 2010). Diabetes mellitus, which was previously considered as single disease, now recognized as a group of disorders and encompasses several types. The most important and common classes of diabetes mellitus are type 1 and type 2. In this Type 1 commonly turns out due to absolute or relative deficiency in insulin secretion as the pancreatic cells are defective. Type 2 diabetes mellitus is a nonautoimmune disease characterized by an elevation in the blood glucose level by a relative deficiency in insulin secretion or insulin resistance (American Diabetes Association, 2015). 1.1 DISARRANGEMENT OF CIRCADIAN RHYTHM - A MAJOR RISK FACTOR FOR TYPE 2 DIABETES MELLITUS Circadian clocks are endogenous oscillators which regulate daily rhythms in normal physiology, metabolism and behavior. In mammals, the suprachiasmatic nucleus (SCN) of hypothalamus is the area where the circadian clock is located,
Book Synopsis Impact of Optimum Diabetes Care on Safety of Fasting Ramadan in Patients with Gestational Diabetes by : Abuelkheir Sona
Download or read book Impact of Optimum Diabetes Care on Safety of Fasting Ramadan in Patients with Gestational Diabetes written by Abuelkheir Sona and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Impact of Optimum Diabetes Care on Safety of Fasting Ramadan in Patients with Gestational DiabetesAuthors:Mohamed Hassanein, Sona Abuelkheir, Manal Twair, Alaaeldin Basheir, Fauzia Rashid, Maryam Al Saeed, Fatima Alsayyah, Fawzi Eltayb, Mohammed Abdellatif, Elamin Abdelgadir ,Azza Khalifa, Fatheya AlawadiBackground: Fasting during Ramadan, is obligatory for all healthy adult Muslims. Many people are exempt from fasting including pregnant women. Indeed, all guidelines consider women with gestational diabetes (GDM) as high-risk group and are advised against fasting. However, many women with GDM insist on fasting in spite of the advice given.Management of GDM is dependent on avoiding postprandial hyperglycaemia as well as hypoglycaemia. However, there is paucity of data looking into GDM management during Ramadan.The use of any type of continuous glucose monitoring (CGM) was not previously evaluated during Ramadan for GDM.This study was approved by our local ethics committee to better understand the safety of fasting for women with GDM who insist on fasting Ramadan.Aim: The primary objective is to study the safety of fasting in patient with GDM in Ramadan in terms of glycemic fluctuations and changes in biometric and biochemical parameters before and after Ramadan.Methods: 25 women with GDM insisting on fasting received optimum care for their diabetes control during Ramadan as follows:u2022tCGM monitoring with Freestyle Libre covering a duration of 6 weeks to include time before, during and after Ramadan. u2022tRamadan and diabetes focused education session. u2022tTreatment was adjusted as per guidelines u2022tAttendance of diabetes antenatal clinics every 1-2 weeks. u2022tBiometric and biochemical data were measured 2-4weeks before and after RamadanResults and Discussion: 72% were emirate; mean gestational age was 26.48 weeks. 66% fasted 21-30 days, 32% were treated with diet only, 48% with metformin only and 20% with insulin and metformin.Data comparing pre to post-Ramadan showed that mean weight increased by 1 kg while there was no significant change in blood pressure or e-GFR. Lipids parameters showed some increase where total cholesterol increased from 133.2 to 151.4 mg/dl, LDL increased from 238 to 248 mg/dl and triglyceride increased from 225 to 267 mg/dl. Mean Fructosamine was unchanged while HbA1c showed slight improvement from 6% to 5.5%. Average number of hypoglycemic events during Ramadan showed increment from 5 to 9 when compared to non-Ramadan. The duration between 12-18hours showed the highest incidence of hypoglycaemic events. The frequency of hypoglycaemic events showed the following:0 events: 2 in Ramadan and 1 in non-Ramadan1-5 events: 3 in Ramadan and 14 in non-Ramadan6-10 events: 6 in Ramadan and 6 in non-Ramadan10-15 events: 8 in Ramadan and 3 in non-Ramadan>15 events: 6 in Ramadan and 1 in non-RamadanThose treated with diet only had 85 hypoglycaemic events in Ramadan and 30 events in non-Ramadan period, those on metformin only had 140 events in Ramadan versus 47 events in non-Ramadan, while those treated with insulin and metformin had 24 events in Ramadan vs 16 events in non-Ramadan. Few patients were using SMBG at the same time as free style Libre. In those who did, hyoglycaemia was confirmed in 3 patients on diet, 7 patients on metformin and 2 for those on insulin with metformin. 16% had no postprandial hyperglycemia (>120mg/dl) after iftar, 64% had 1 to 5 events, 12% had 6 to 10 events and 8% had more than 10 events. None needed admission for any reason.Conclusion:Many women with GDM fasted in Ramadan. However, hypoglycaemic events increased significantly during Ramadan fasting even for those on diet only or in those treated with metformin while assessed by free style Libre. The time between 12-18 hours had the highest incidence of hypoglycemic episodes. With the exception of lipids profile, there was no significant change in biochemical or biometric parameters. None was admitted to hospital. This data are of important clinical implications and need to be repeated again with a larger cohort and with clear advice to re-check with SMBG if results indicate hypoglycaemia to confirm it and to assess the accuracy of free style Libre and or any other CGM in pregnant women with GDM during fasting Ramadan.
Book Synopsis The Diabetes Code by : Dr. Jason Fung
Download or read book The Diabetes Code written by Dr. Jason Fung and published by Greystone Books Ltd. This book was released on 2018-04-03 with total page 245 pages. Available in PDF, EPUB and Kindle. Book excerpt: FROM NEW YORK TIMES BESTSELLING AUTHOR DR. JASON FUNG • “The doctor who invented intermittent fasting.” —The Daily Mail “Dr. Fung reveals how [type 2 diabetes] can be prevented and also reversed using natural dietary methods instead of medications … This is an important and timely book. Highly recommended.” —Dr. Mark Hyman, author of The Pegan Diet “Dr. Jason Fung has done it again. … Get this book!” —Dr. Steven R. Gundry, author of The Plant Paradox Everything you believe about treating type 2 diabetes is wrong. Today, most doctors, dietitians, and even diabetes specialists consider type 2 diabetes to be a chronic and progressive disease—a life sentence with no possibility of parole. But the truth, as Dr. Fung reveals in this groundbreaking book, is that type 2 diabetes is reversible. Writing with clear, persuasive language, Dr. Fung explains why conventional treatments that rely on insulin or other blood-glucose-lowering drugs can actually exacerbate the problem, leading to significant weight gain and even heart disease. The only way to treat type 2 diabetes effectively, he argues, is proper dieting and intermittent fasting—not medication. “The Diabetes Code is unabashedly provocative yet practical ... a clear blueprint for everyone to take control of their blood sugar, their health, and their lives.”—Dr. Will Cole, author of Intuitive Fasting
Book Synopsis Ramadan Free For Diabetes by : Maryam Isah
Download or read book Ramadan Free For Diabetes written by Maryam Isah and published by Independently Published. This book was released on 2023-03-29 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managing Diabetes During Ramadan" is an insightful and informative guide that explores the challenges and opportunities faced by Muslims with diabetes during the holy month of Ramadan. This comprehensive book is written by leading experts in diabetes management and provides practical advice, tips, and strategies for individuals with diabetes who wish to fast during Ramadan. In this book, you will discover how to safely and effectively manage your blood glucose levels while fasting, how to adjust your medication and insulin dosage, and how to plan your meals and physical activity to maintain your health and wellbeing. You will also learn about the spiritual and cultural significance of Ramadan, and how to balance your religious observance with your diabetes management. Whether you have type 1 or type 2 diabetes, this book is a must-read for anyone who wants to fast during Ramadan while managing their diabetes. With its clear and concise writing, easy-to-follow guidelines, and practical tips, "Managing Diabetes During Ramadan" is the perfect resource for anyone looking to stay healthy and stay true to their faith during this special time of the year. Get your copy today and start your journey towards a healthier and more fulfilling Ramadan experience!
Book Synopsis The Impact of Ramadan Fasting on the Glycemic Control of Type 2 Diabetes Mellitus Patients: a Systematic Review by : Cindy Astrella
Download or read book The Impact of Ramadan Fasting on the Glycemic Control of Type 2 Diabetes Mellitus Patients: a Systematic Review written by Cindy Astrella and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Majority of Muslim with type 2 diabetes mellitus (T2DM) fasted during Ramadan regardless of possible health risk complication. Despite reports on the beneficial impact of intermittent fasting on the glycemic control of T2DM, the impact of Ramadan fasting has been inconsistent. This systematic review aims to assess the impact of Ramadan fasting on the glycemic control of T2DM patients.Methods: Literature searching was done at March 2019 at PUBMED, EBSCOhost and Proquest database using combination of the following keywords: Ramadan fasting, type 2 diabetes mellitus, glycemic profile, fasting glucose and HbA1c. Observational studies conducted in adult human, published in English within 10 years which analyze the glucose parameter (fasting plasma glucose or FPG and HbA1c) among T2DM patients during Ramadan fasting were included in the data analysis. All studies were assessed for its risk of bias using New-Castle Ottawa Scale. The heterogeneity of the studies was analyzed using I2 (square) test and the overall mean difference between FPG and HbA1c before and after Ramadan fasting was calculated using Weighted Mean Difference (WMD) test using Stata 13.Results: A total of 13 observational studies with moderate to high quality that were conducted in Middle Eastern and Asian countries were included in the data analysis. The included studies recruited T2DM patients aged 49 to 60 year olds who fasted for 10 days to full Ramadan month. All of the included studies were considered heterogeneous with I2 >75%. Two studies reported an increase in FBG level while four studies reported the contrary. Whereas two studies reported a significant increase in HbA1c level, seven studies reported the contrary, and one study reported neutral effect. In the WMD pooled analysis, the mean FBG level decreased by -0.72 mmol/L (95%CI -0.88-(-0.56), p
Book Synopsis Impact of Ramadan Fasting on Glycemic Control in Patients with Diabetes and Coronary Heart Disease by : Rashid Fauzia
Download or read book Impact of Ramadan Fasting on Glycemic Control in Patients with Diabetes and Coronary Heart Disease written by Rashid Fauzia and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Impact of Ramadan Fasting on Glycemic Control in Patients with Diabetes & Coronary Heart DiseaseMohamed Hassanein, Fauzia Rashid, Mohammed Abdel latif, Alaaeldin BasheirMaryam Al Saeed, Elamin Abdelgadir, Sona Abul kheir, Azza Khalifa, Fawzi El tayebFatima Alsayyah, Suzan Jacob , Fatheya AlawadiBackgroundCardiovascular disease is a leading cause of morbidity and mortality in patients with diabetes especially in middle and low-income countries in the world (1) where the Muslims are predominant. Most of Muslims patients with diabetes and CVD elect to fast in Ramadan, but the actual risk in the different subset of patients with CVD is largely unknown. Considering the extended fasting hours theoretically, may increase the possibility of hyperviscosity and thrombosis. This factor along with possible missed or altered timings for essential medicines and occurrence of hypoglycemia can cause deleterious cardiovascular effects. Only a few studies are done in patients with diabetes and Coronary heart disease (CHD) with an aim to observe any adverse cardiovascular outcome in Ramadan (2,3,4). To the best of our knowledge, no study is done so far to monitor the effect of Ramadan fasting on glycemic control and frequency of hypoglycemia in these high-risk patients with the use of continuous glucose monitor(CGM) and to correlate it with an adverse cardiovascular event in Ramadan fasting.AimWe sought to understand the safety of fasting in CHD patients with diabetes insisting on fasting Ramadan. We conducted this prospective study in a tertiary care hospital in Dubai during Ramadan 2016 that from June 6th till July 5th. PATIENTS AND METHODSPatient with T2DM with stable known CHD since last three months and insisted on fasting despite advice against it was randomly selected from endocrine and cardiology clinic 1 to 2 months before Ramadan, counselled, and asked to sign an informed consent. Patients with the concurrent renal disease or any recent hospitalisation in last 3 months were excluded. All the patients received 90 minutesu2019 session for Ramadan-focused education. The Libre flash sensor insertion is done for continuous glucose monitoring. Their biophysical and biochemical profile was collected 2 to 4 weeks before and after Ramadan. We recorded DM or CVD-related emergency visit or hospitalisation, change in BMI, systolic and diastolic BP, HBA1c, and frequency of hypoglycemia during Ramadan fasting and not -fasting period. All the quantitative values are described as mean, and analysis of CGM data is shown in frequencies.RESULTSWe recruited 26 patients,1 patient did not fast in Ramadan after signing consent as scheduled for surgery and 4 patients did not complete the protocol. There were 21 final participants,15 males and 6 females with mean age of 58 years (range 34-71). Anti- diabetic regime included basal or basal bolus or premixed insulins with or without combination with other oral agents. An average number of days fasting were 28. 90% patients (n=18) completed >20 days fasting. 19% patients (n=4) broke their fast. 47% patients (n=10) experienced symptomatic hypoglycemia. However none of them reported severe hypoglycemia, one patient visited emergency department with dyspnea after Ramadan. Most patients have 3 sensors attached to them with average 3 weeks during Ramadan and 3 weeks outside Ramadan (Sha'ban and shawal). The sensor data showed peak mean glucose during Ramadan was 281mg/dl (191-393) and none- Ramadan was 275 (131-444) with mean HBA1c of 7.9% and 7.3% respectively. Total 67 episodes of hypoglycemia with lowest mean glucose of 60mg/dl (40-121) recorded during Ramadan while non- Ramadan period 24 hypoglycemic events and lowest mean glucose value was 67mg/dl (40-142). The average duration for hypoglycemia was 118 minutes (30-340) in Ramadan and 49 minutes (30-184) in non- Ramadan. The mean glucose value below 60mg/dl recorded in 78% of patients in Ramadan and 40% of patients during non -Ramadan.During fasting Ramadan 76% patients had 1-10 and 5% had more than 10 episodes of hypoglycemia however 51% had experienced 1 to 10 episodes, and 49% of them never had any hypoglycemia recorded in non- fasting state. Conclusion: This is first ever to study using CGM in high-risk CHD patients to objectively assess the glycemic changes and frequency of hypoglycemia and its correlation with any adverse CVD effect. Patients had 2.7 times higher incidence of hypoglycemia that is more marked and prolonged during fasting compared to non-fasting. No significant alteration was seen in BMI, SBP and DBP, HBA1c, lipid profile and hepatic functions. Studies with larger sample size needed for further validation of these findings.References1.tInternational Diabetes Federation. Diabetes and cardiovascular disease. Brussels, Belgium: International Diabetes Federation, 2016. www.idf.org/cvd 2.tChamsi-Pasha M, Chamsi-Pasha H. The cardiac patient in Ramadan. Avicenna J Med. 2016;6(2):33. 3.tMousavi M, Mirkarimi S, Rahmani G, Hosseinzadeh E, Salahi N. Ramadan fast in patients with coronary artery disease. Iran Red Crescent Med J. 2014 Dec;16(12):e7887. 4.tSalim I, Al Suwaidi J, Ghadban W, Alkilani H, Salam AM. Impact of religious Ramadan fasting on cardiovascular disease: a systematic review of the literature. Curr Med Res Opin. 2013 Apr;29(4):343u201354.
Book Synopsis Effect of Fasting Ramadan on Different Laboratory Parameters in Egyptian Patients with Type 2 Diabetes Mellitus by : Aboromia Maram
Download or read book Effect of Fasting Ramadan on Different Laboratory Parameters in Egyptian Patients with Type 2 Diabetes Mellitus written by Aboromia Maram and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BackgroundMost of the diabetic Muslims have strong desire to fast during the month of Ramadan. Butsome of them cannot perform it as there is a risk of an assortment of complications like hypoglycemia or hyperglycemia. During Ramadan, the meal pattern and fluid intake is markedly altered and there are delayed and shortened periods of sleep. It would be possible that these changes in meal and sleeping rhythm could lead to an undesirable change in metabolism and increase risk of complications like hypoglycemia, hyperglycemia, diabetic ketoacidosis, dehydration and thrombosisAimTo Study the effect of Ramadan Fasting on metabolic parameters and cardiovascular disease risk in patients with type 2 diabetes mellitusMethodsThis study was conducted on total of 80 patients with type 2 diabetes mellitus who were intending to fast Ramadan in (2014) the average fasting hours were 15 h. They were subjected to clinical, anthropometric and laboratory evaluation before Ramadanand after RamadanResultsThere was a significant increase between pre and after Ramadan values as regards serum cholesterol, mean difference (56.62md/dl) triglyceride(46.61mg/dl), LDL cholesterol (38.36mg/dl) Fasting insulin(6.53mu/l), HOMA IR (4.56 IU) , serum Creatinine (0.12mg/dl) , Systolic blood pressure(SBP) (6.28 mmHg), Diastolic blood pressure(DBP) (7.13 mmHg), andthe 10 years cardiovascular disease(CVD) risk was increased by(2.38). There was no significant difference as regard Body mass index. There was a significant positive correlation between 10 years CVD risk and Fasting insulin (r = 0.24), SBP ( r = 0.62), DBP (r = 0.60).The most important predictors of CVD were smoking (P= 0.000) followed by cholesterol and triglyceride with values of ( P=0.248) and P=0.067), respectively. Conclusion Ramadan fasting appears to have significant effect on lipid profiles and insulin resistance that could adversely impact cardiovascular outcome, these effects may be attributed tothe quality & quantity of food intake and the negative impact of sedentary life style, we recommend that Pre-Ramadan counselling , education , lifestyle modification and moderate physical activitywouldimprove the benefits of fasting on health outcome.
Book Synopsis Characteristics and Pattern of Care of Type 1 and 2 Diabetic Patients During Ramadan: an International Prospective Study by : Hassanein Mohamed
Download or read book Characteristics and Pattern of Care of Type 1 and 2 Diabetic Patients During Ramadan: an International Prospective Study written by Hassanein Mohamed and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Characteristics and Pattern of Care of Type 1 And 2 Diabetic Patients during Ramadan;An International Prospective Observational StudyBackgroundOver 116 million Muslims with Diabetes fast from dawn to sunset during the holy month of Ramadan (a Lunar-based month) 1, 2. The CREED study reported that 94.2% of type 2 diabetes patients fast for a minimum of 15 days while 64% fast every day during Ramadan 3.Ramadan fasting may increase the risk of hypoglycemia, hyperglycemia, diabetic ketoacidosis, dehydration and thrombosis 2.To minimize these risks, HCPs must pay attention to pre-Ramadan glycemic control status, patient education, diet, physical activity, SMBG and adaptations in treatment regimen 4, 5.This raised the need for exploring real life practices to enhance evidence-based management of the disease during Ramadan fasting especially that most of the evidence is retrospective data and in need for an update 3, 6.AimsIn addition to updating description of Type 1 and Type 2 diabetic patients pattern of care, this study aimed to investigate the effect of fasting during Ramadan on glycemic control, lifestyle, body weight, treatment and patient safety.MethodsThis international, prospective, observational study recruited 1894 adult diabetic patients (Type 1 and Type 2) by 113 sites from 10 countries; Egypt, KSA, Pakistan, UAE, Jordan, Morocco, Lebanon, Kuwait, Israel and Iraq. Informed consent was obtained from all patients prior to enrollment. A total of 1885 patients were evaluable.Baseline data were collected during a visit in the six weeks prior to Ramadan and a follow-up visit was conducted at one to two months after Ramadan. Preliminary results of the study will be discussed in this abstract. ResultsOf the evaluable population, 55.6% were men. The meanu00b1 SD age was 53.5u00b1 12.5 years. Patients with type 2 diabetes constituted 92.8% of the population.Based on the data collected before Ramadan, 87.8% of the patients were on oral anti-diabetic drugs (OADs), 36.3% were on insulin and 4.9% were on GLP-1 receptor agonists. Of these patients, 24.5% were on OADs and Insulin. A total of 925 patients (49.1%) had their anti-diabetic medications/ doses changed for Ramadan (31.5% of OADs, 23.0% of insulin and 0.3% of GLP-1 receptor agonists). More than half of the patients (59.5%) reported that they had an access to Ramadan-specific diabetes education. Data collected after Ramadan showed that, 56.7% of the patients fasted everyday during Ramadan with a higher percentage (p=0.05) in type 2 patients (57.3%) compared to type 1 patients (48.5%). A similar pattern was seen for patients who fasted for a minimum of 15 days (85.3%): the percentage in type 2 patients (86.3%) was higher (p
Book Synopsis A Study of the Fasting Diabetic Patients During the Month of Ramadan by : M. Mafauzy
Download or read book A Study of the Fasting Diabetic Patients During the Month of Ramadan written by M. Mafauzy and published by . This book was released on 1990 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Impact of Ramadan Fasting on Glycemic Control and Kidney Function in Patients with Diabetes and Chronic CKD Stage 3 by : Rashid Fauzia
Download or read book The Impact of Ramadan Fasting on Glycemic Control and Kidney Function in Patients with Diabetes and Chronic CKD Stage 3 written by Rashid Fauzia and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The impact of Ramadan fasting on Glycemic Control and Kidney Function in Patients with Diabetes and Chronic Kidney Disease stage 3.Fatheya Alawadi , Fauzia Rashid, Alaaeldin Basheir, Elamin Abdelgadir, Maryam Al Saeed, Sona AbuAlkheir, Fatima Alsayyah, Azza Khalifa, Fawzi El tayeb, Mohammed Abdellatif, Khadija AbdAllah , Mohamed HassaneinBackgroundGlobal prevalence of chronic kidney disease (CKD) in patients with diabetes is rising over the last two decades. Wild et. al. estimated this increment from 2.8% to 4.4% of total diabetes population by the year 2030 (1). Unfortunately, diabetes and its complications are more endemic in the under-developed and developing countries; the areas where the Muslims are majority, therefore, fasting Ramadan will be an important religious/health issue. The patients with diabetes and renal impairment are considered high risk for fasting due to the relative increased risk of hypoglycemia and the possible worsening of renal functions due to prolonged dehydration hours, however, many usually prefer to fast despite advice against it (2,3). There are few studies that assessed the impact of fasting on the kidney function at different stages of renal jeopardy with very variable results (4,5,6). To our best research and knowledge, there is no study available till date that used continuous glucose monitoring in patients with diabetes and renal impairment aiming for objective stratification of hypoglycemia risk in this group of patients. Aim of the studyTo understand the risk of hypoglycaemia during Ramadan fasting as well as the renal and other metabolic changes after Ramadan in patients with diabetes and chronic kidney disease stage 3. We aimed to conduct this prospective study in a tertiary care hospital in Dubai during Ramadan 2016 that from June 6th till July 5th. METHODSAdult patient aged between 18 to 70 years with type 2 diabetes (T2DM) and stable CKD stage-3 (estimated glomerular filtration rate 30-60 ml/min), who insisted on fasting, were randomly selected from endocrine and nephrology clinic 1 to 2 months before Ramadan, counseled, and asked to sign an informed consent. Patients with any recent hospitalisation or with known cardiovascular disease were excluded. All the patients received a 60 minutesu2019 session of Ramadan-focused diabetes education. After the education, a Libre free style sensor was inserted for continuous glucose monitoring. Their biophysical and biochemical profile was recorded 2-4 weeks before and after Ramadan. We recorded the change in weight, Body mass index, systolic and diastolic blood pressure, HBA1c, lipids profile, renal functions, and frequency and pattern of hypoglycemia during Ramadan fasting and non -fasting period. RESULTS and discussion Total of 25 patients were recruited. Out of which, one patient did not manage to fast in Ramadan due to ill-health feeling. Another five patients dropped out during the study. 19 patients completed the study, 11 were males, and 8 were females with the mean age of 62 (u00b114 years). 95% (n=18) of patients fast for more than 15 days and average days of fasting were 27. During Ramadan 42% (n=8) patients experienced symptomatic hypoglycemia, however, none of them reported severe hypoglycemia, emergency room visit or hospitalisation due to any cause during the study period.Most patients had three sensors during the study, covering an average three weeks during Ramadan and three weeks outside Ramadan (Sha'ban and shawal). The captured data from the sensors showed peak glucose of 333mg/dl during Ramadan and 295mg/dl outside Ramadan while the lowest mean glucose was 70mg/dl (Ranged 40-110) and 94mg/dl (Ranged 43-258) respectively. Total 42 events of hypoglycemic episodes were recorded during the non-Ramadan period with a mean duration of 44 minutes (range 15-120), and that increased to 80 events during fasting with an average length of 100 minutes (range30u2014500) during Ramadan. The glucose level below 60mg/dl in CGMS was seen in 50% of patients in Ramadan and 45% during nonu2013Ramadan period. This increased frequency and duration of low glucose levels was later reflected as improvement in their HBA1c from 7.9% to 7.6% pre-and post-Ramadan. No significant difference was observed in weight, blood pressure and renal functions measured as serum urea, creatinine, e-GFR, electrolytes before and after Ramadan fasting.Conclusion: This study is unique by providing CGMS with high quality medical care in such a high-risk group of patients. Patients with DM and moderate renal impairment experienced prolonged and more frequent hypoglycemia during Ramadan compared to non- Ramadan period. However, no severe hypoglycemia or hospitalisation or deterioration in renal functions was observed.To anchor these findings, and to further confirm the risk stratification of diabetes patients during Ramadan; larger multicenter studies are necessary.References:1.tWild S., Roglic G., Green A., Sicree R., King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047u20131053. doi: 10.2337/diacare.27.5.1047.2.tSalti I, Bu00e9nard E, Detournay B, Bianchi-Biscay M, Le Brigand C, The EPIDIAR Study Group, et al. A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries: results of the Epidemiology of Diabetes and Ramadan 1422/2001 (EPIDIAR) study. Diabetes Care. 2004;27:2306u201311.3.tIDF. & DAR International Alliance2016. Diabetes and Ramadanu202f: Practical Guidelines,4.tAl Wakeel J, Mitwalli AH, Alsuwaida A, Al Ghonaim M, Usama S, Hayat A, et al. Recommendations for fasting in Ramadan for patients on peritoneal dialysis. Perit Dial Int. 33(1):86u201391. 5.tKara E, Sahin OZ, Kizilkaya B, Ozturk B, Pusuroglu G, Yildirim S, et al. Fasting in Ramadan is not associated with deterioration of chronic kidney disease: A prospective observational study. Saudi J Kidney Dis Transpl. 28(1):68u201375. 6.tNasrAllah MM, Osman NA. Fasting during the month of Ramadan among patients with chronic kidney disease: renal and cardiovascular outcomes. Clin Kidney J. 2014 Aug 1;7(4):348u201353.
Book Synopsis Comparative Physiology of Fasting, Starvation, and Food Limitation by : Marshall D. McCue
Download or read book Comparative Physiology of Fasting, Starvation, and Food Limitation written by Marshall D. McCue and published by Springer Science & Business Media. This book was released on 2012-05-17 with total page 431 pages. Available in PDF, EPUB and Kindle. Book excerpt: All animals face the possibility of food limitation and ultimately starvation-induced mortality. This book summarizes state of the art of starvation biology from the ecological causes of food limitation to the physiological and evolutionary consequences of prolonged fasting. It is written for an audience with an understanding of general principles in animal physiology, yet offers a level of analysis and interpretation that will engage seasoned scientists. Each chapter is written by active researchers in the field of comparative physiology and draws on the primary literature of starvation both in nature and the laboratory. The chapters are organized among broad taxonomic categories, such as protists, arthropods, fishes, reptiles, birds, and flying, aquatic, and terrestrial mammals including humans; particularly well-studied animal models, e.g. endotherms are further organized by experimental approaches, such as analyses of blood metabolites, stable isotopes, thermobiology, and modeling of body composition.
Book Synopsis Attitude and Practice of Muslim Patients with Type 2 Diabetes During Ramadan - a Hospital Based Study from South India by : Sankar Prasanth
Download or read book Attitude and Practice of Muslim Patients with Type 2 Diabetes During Ramadan - a Hospital Based Study from South India written by Sankar Prasanth and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BackgroundRamadan fasting is one among the 5 pillars of Muslim religious obligation. Although Holy Quran exempts fasting in those with acute or chronic illness, most Muslim diabetic patients wish to participate and do so. Being a religious matter, a recommendation of contraindication cannot be forced upon those who wish to fast. The knowledge, attitude and practices of Type 2 Diabetes (T2DM) patients during Ramadan fasting in Kerala is little known.AimTo assess the knowledge, attitude and practice of Muslim patients with T2DM during Ramadan in visiting a Multispecialty Hospital in South Kerala.MethodA questionnaire based cross sectional study was conducted among 152 consecutive Muslim T2DM patients visiting the outpatient Diabetes Clinic of a multispecialty hospital in Pathanamthitta district of South Kerala. The study was conducted 3 months prior to Ramadan. The eligibility criteria of inclusion were all Muslim patients with a diagnosis of T2DM for more than one year who had decided to fast in Ramadan and willing to participate after giving informed consent. Data were entered in to Microsoft Excel and statistical analysis was done using SPSSv15.ResultsMean age of the study population was 56.84 u00b1 9.44 years. Females constituted 47.4%. Education was below 10th standard in 69.7% of population. Majority of females were housewives (89.9%), whereas males were either businessmen (35.0%) or retired government servants (35.0%). Duration of T2DM was between 5 to 15 years in 53.9 % while 26.3 % had T2DM for more than 15 years. Only 67.1% of patients had their HbA1c tested during the previous 3 months. Among these 56.9% had HbA1c more than 8%. Among the 152 patients, 92% fasted during the previous year. More than 90% of these patients fasted 25 days or more. Hypoglycemia and fatigue were main reasons for breaking fast. Insulin was used by 30.3% of those who fasted during the previous year. Ramadan specific exercise program was practiced only by 10.5% of patients. Only 21.1% used to perform SMBG during fasting, majority being females (p-0.006) and those using insulin (p
Book Synopsis Caring for Muslim Patients by : Aziz Sheikh
Download or read book Caring for Muslim Patients written by Aziz Sheikh and published by Radcliffe Publishing. This book was released on 2008 with total page 158 pages. Available in PDF, EPUB and Kindle. Book excerpt: Muslim patients customarily have particular ways of approaching health and healthcare. This book addresses common misunderstandings and bridges cultural gaps. It includes a profile of the Islamic worldview, taking an 'insiders perspective' and explores the concept of health and disease within this paradigm.
