Impact Of Ramadan Fasting On Glycemic Control In Type 2 Diabetic Patients Treated With Insulin

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Impact of Ramadan Fasting on Glycemic Control in Type 2 Diabetic Patients Treated with Insulin

Author : Imen Sebai
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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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.

Ramadan & Diabetes Care

Author : Abdul Hamid Zargar
Publisher : JP Medical Ltd
ISBN 13 : 9350907003
Total Pages : 232 pages
Book Rating : 4.3/5 (59 download)

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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

The Impact of Ramadan Fasting on the Glycemic Control of Type 2 Diabetes Mellitus Patients: a Systematic Review

Author : Cindy Astrella
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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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

Characteristics and Pattern of Care of Type 1 and 2 Diabetic Patients During Ramadan: an International Prospective Study

Author : Hassanein Mohamed
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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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

The Impact of Ramadan Fasting on Glycemic Control and Kidney Function in Patients with Diabetes and Chronic CKD Stage 3

Author : Rashid Fauzia
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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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.

Impact of Ramadan Fasting on Glycemic Control in Patients with Diabetes and Coronary Heart Disease

Author : Rashid Fauzia
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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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.

Attitudes, Behavior and Impact of Ramadan Focused Patient Education in High-risk Groups with Dm During Ramadan Fasting

Author : Alawadi Fatheya
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis Attitudes, Behavior and Impact of Ramadan Focused Patient Education in High-risk Groups with Dm During Ramadan Fasting by : Alawadi Fatheya

Download or read book Attitudes, Behavior and Impact of Ramadan Focused Patient Education in High-risk Groups with Dm During Ramadan Fasting written by Alawadi Fatheya and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background:Management of diabetes during Ramadan fasting can be a challenge for people with diabetes as well as for healthcare professionals. Recent studies indicates that the 94% of people with type 2 diabetes wish to fast, however, only 67% of them are able to fast the full month (1). Many of these are fasting against medical advice. Equally, the advice from healthcare professionals varies greatly from country to country. CREED study indicated that while in Algeria 83.5% of people with diabetes fasted every day, in neighboring country; Morocco only 22.9% did fast (2). This probably reflects the different advise from healthcare professionals in these two countries. Similarly, Ramadan-focused education has previously shown lower risk of hypoglycaemia during Ramadan (3). However, no previous studies have looked into the attitude, behavior and impact of Ramadan focused education in those considered as high-risk group for Ramadan fasting. Therefore, this study is the first study that includes very high/high risk category groups for fasting Ramadan and should help better understanding of diabetes and Ramadan fasting in such group. Aims:We aimed to assess the attitude and behavior as well as the impact of Ramadan focused education for very high/high risk group for fasting Ramadan. This included people with type1 diabetes, people with type2 diabetes treated with insulin, people with stable CVD and diabetes, people with CKD stage 3 and diabetes as well as women with gestational diabetes during Ramadan. METHODS: 168 person with type1 diabetes, people with type2 diabetes treated with insulin, people with stable CVD and diabetes, people with CKD stage 3 and diabetes as well as women with gestational diabetes who insisted on fasting Ramadan were recruited to the Dubai Hospital, Diabetes and Ramadan study. Our local ethics committee approved this study. All patients consented to take part in the study. They were all invited to attend a Ramadan focused patient education session. A questionnaire was applied prior to, and at the end of the educational session. 1-2 months post Ramadan the questionnaire was repeated again. Freestyle Libre CGM was provided to all patients to look into the glucose changes pre, during and immediately post Ramadan. Meanwhile, biometric (Weight, height, Blood pressure) and biochemical (Glycosylated hemoglobin-A1c, lipids profile, creatinine, and estimated glomerular filtration rate) were reported within 2 to 4 weeks before and after Results and discussion: All patients reported improved confidence in knowledge for safe fasting except for the GDM group where this reduced from pre-session value of 92% to post session level of 70%. The educational benefit of the educational session was reported at 93%. The overall average fasting days of the whole group was 27.7 days ranging from 24.1 days in type1 diabates to 29.6 in GDM. Fasting for the full moth of Ramadan was achieved by 64% of this high-risk group, which matches that achieved in by the overall diabetes community reported in CREED study (2). This average rate of fasting varied from as low as 21% in type1 diabetes to 85% in those with diabetes and stable CVD. On the contrary, change in medication was practiced by 63% of type1 patients compared to 26% in diabetes and stable CVD. This might reflect the type of treatment used. Hypoglycaemia measured by CGM data increased from 44% pre-Ramadan to 60% during Ramadan. Breaking fasting when hypoglycaemic was practiced by 85% of the overall cohort which higher than previous data from the same region few years ago (4) and might reflect the impact of Ramadan focused education as well as the availability of CGM data. On the other hand, this still indicates that 15% are not breaking the fast when their results indicate blood glucose level

A Study of the Knowledge, Attitude and Practice and the Effect of Ramadan Fasting on Glycemic Control and Hydration Status of Type 2 Diabetic Patients in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan

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Author : Nor Azwany Yaacob
Publisher :
ISBN 13 :
Total Pages : 230 pages
Book Rating : 4.:/5 (96 download)

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Book Synopsis A Study of the Knowledge, Attitude and Practice and the Effect of Ramadan Fasting on Glycemic Control and Hydration Status of Type 2 Diabetic Patients in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan by : Nor Azwany Yaacob

Download or read book A Study of the Knowledge, Attitude and Practice and the Effect of Ramadan Fasting on Glycemic Control and Hydration Status of Type 2 Diabetic Patients in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan written by Nor Azwany Yaacob and published by . This book was released on 2003 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Ramadan Fasting and Diabetes

Author : Sharmin Hossain
Publisher : LAP Lambert Academic Publishing
ISBN 13 : 9783848403561
Total Pages : 56 pages
Book Rating : 4.4/5 (35 download)

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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.

Impact of Optimum Diabetes Care on the Safety of Fasting in Ramadan in Adult Patients with Type 1 Diabetes Mellitus

Author : Al Saeed Maryam
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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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.

Impact of Structured Education on Diabetes Management During Ramadan

Author : Jalali Mohammad Hossein
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis Impact of Structured Education on Diabetes Management During Ramadan by : Jalali Mohammad Hossein

Download or read book Impact of Structured Education on Diabetes Management During Ramadan written by Jalali Mohammad Hossein and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Impact of structured education on diabetes management during RamadanM.H. Jalali1, F. Mahmoud2, N. othman2, N. Al matrouk3, A. Monira4, A. Bennakhi4.1Dasman Diabetes Institute, nursing, kuwait, Kuwait.2Dasman Diabetes Institute, Education, kuwait, Kuwait.3Dasmani Diabetes Institute, Education, Kuwait, Kuwait.4Dasman Diabetes Institute, Research, Kuwait, Kuwait.Background Fasting during Ramadan is an obligatory duty for all healthy adult Muslims. Although Islam exempts people with chronic medical conditions from the duty of fasting, many people with diabetes insist on fasting Ramadan despite the medical advice not to. Fasting among people with type 1 & 2 diabetes is associated with multiple risks such as hypoglycemia, hyperglycemia, and others. The practice in Dasman Diabetes Institute is to conduct an annual educational course 2-3 months before the start of the holy month of Ramadan.AimTo evaluated the impact of implementing a structured education program in preventing diabetes associate complications of fasting.MethodA customized version of MADAR (Measured Approach for Diabetes and Ramadan) has been adopted, adapted and implemented for this purpose. Educators, nutritionists, nurses and physicians are involved in this program. All participants filled a questionnaire, covering different aspects related to the effect of fasting and diabetes, before and after Ramadan. The course is a one day of 3 hours duration. It consists of two parts; basic diabetes and nutritional concepts. The questionnaire covers a brief medical history and past experience of any complication of fasting in previous months of Ramadan. Confidence rate to manage diabetes outcomes during fasting is also assessed. Results215 patients, 118 male and 97 female, were invited and accepted to participate in the program. Only 18/215 were T1DM, the remaining 197 were T2DM. The mean age of the participants was 56.1 year. There was a significant improvement of confidence rate to manage diabetes outcomes during fasting. There was 46.9% reduction in hypoglycemic events and an overall improvement in glycemic control by 1.1% of HbA1c.Discussion Ramadan-focused structural diabetes education program can empower patients to change their lifestyle during Ramadan and it reduces the risks associated with fasting in people with diabetes.

Effect of Fasting Ramadan on Different Laboratory Parameters in Egyptian Patients with Type 2 Diabetes Mellitus

Author : Aboromia Maram
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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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.

Metabolic Perturbations in Type Two Diabetes During Ramadan Fasting

Author : Sandhya A. M
Publisher :
ISBN 13 :
Total Pages : 124 pages
Book Rating : 4.2/5 (11 download)

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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,

Impact of Ramadan Fasting on a Saudi Population with Type 2 Diabetes Mellitus

Author : Abdullah Alghamdi
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (123 download)

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Book Synopsis Impact of Ramadan Fasting on a Saudi Population with Type 2 Diabetes Mellitus by : Abdullah Alghamdi

Download or read book Impact of Ramadan Fasting on a Saudi Population with Type 2 Diabetes Mellitus written by Abdullah Alghamdi and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Global Report on Diabetes

Author : Gojka Roglic
Publisher :
ISBN 13 : 9789241565257
Total Pages : 0 pages
Book Rating : 4.5/5 (652 download)

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Book Synopsis Global Report on Diabetes by : Gojka Roglic

Download or read book Global Report on Diabetes written by Gojka Roglic and published by . This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "On the occasion of World Health Day 2016, WHO issues a call for action on diabetes, drawing attention to the need to step up prevention and treatment of the disease. The first WHO Global report on diabetes demonstrates that the number of adults living with diabetes has almost quadrupled since 1980 to 422 million adults. This dramatic rise is largely due to the rise in type 2 diabetes and factors driving it include overweight and obesity. In 2012 alone diabetes caused 1.5 million deaths. Its complications can lead to heart attack, stroke, blindness, kidney failure and lower limb amputation. The new report calls upon governments to ensure that people are able to make healthy choices and that health systems are able to diagnose, treat and care for people with diabetes. It encourages us all as individuals to eat healthily, be physically active, and avoid excessive weight gain."--Publisher's description.

Attitude and Practice of Muslim Patients with Type 2 Diabetes During Ramadan - a Hospital Based Study from South India

Author : Sankar Prasanth
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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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

Take Control of Your Cancer Risk

Author : John Whyte, MD, MPH
Publisher : Harper Horizon
ISBN 13 : 0785240411
Total Pages : 269 pages
Book Rating : 4.7/5 (852 download)

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Book Synopsis Take Control of Your Cancer Risk by : John Whyte, MD, MPH

Download or read book Take Control of Your Cancer Risk written by John Whyte, MD, MPH and published by Harper Horizon. This book was released on 2021-10-05 with total page 269 pages. Available in PDF, EPUB and Kindle. Book excerpt: Something everyone has the power to do is reduce your cancer risk, and this book will show you just how easy it is to do it. Each year, over a million people in the United States alone hear the words no one ever wants to hear: You have cancer. But what if there was a way for fewer people to hear these words? One of the biggest myths regarding cancer is that it’s mostly genetic - meaning that you have no control over whether you get it. While genetics do have an impact, the truth is that your lifestyle and environment play the major role. Physician and Chief Medical Offer of WebMD John Whyte, MD, MPH, shares straightforward information and equips you with strategies to help you on a journey to better health. In Take Control of Your Cancer Risk, Dr. Whyte provides helpful tips including: assessing your cancer risk knowing which screenings you need, and when learning the role food, exercise, and sleep play understanding the relationship between stress and cancer Take Control of Your Cancer Risk is filled with practical advice that empowers you to really take control of our health.