SAT164 Hypoglycemia Risk And Glucose Parameters In Pregnant Women With Or Without Diabetes During Fasting Ramadan
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PROVIDER: S-EPMC10554447 | biostudies-literature | 2023 Oct
REPOSITORIES: biostudies-literature
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Project description:Purpose:The study aims to assess current practices of patients with diabetes to control blood glucose levels during Ramadan. Patients and Methods:A cross-sectional approach has been used for collecting data through a structured and interview-based questionnaire to assess the association between self-monitoring of blood glucose (SMBG) and hypoglycemia. The questionnaire has recorded information about demographics, duration of diabetes, and treatment of diabetes, and hypoglycemia complications faced during Ramadan. The primary outcomes of this study include frequency of SMBG during fasting in Ramadan and association of SMBG and hypoglycemia and break of fasting. However, the secondary outcomes include medications, glycemic control, and other influencing factors. The data was analyzed using Statistical Package of Social Sciences (SPSS) version 20. Results:The findings have shown that the majority of the patients used a combination of metformin+sulphonylurea (23.02%) following metformin+insulin (20.86%), insulin (12.94%), and metformin (8.63%). Whereas diet control, high or low blood sugar, insulin dose adjustment in fasting conditions were the most influential factors during Ramadan when the blood sugar levels were tested. Majority of the patients monitored their blood glucose level during pre-iftar (56.8%) following to hypoglycemia (30.2%), post-iftar (29.4%), and rarely monitored in afternoon (3.5%) despite that only 10.1% monitored their blood glucose on a daily basis. Patients who had symptoms of hypoglycemia and had to break their fasting at least once were 41% and 27.2%, respectively. There is a significant association between age and gender with symptoms of low blood sugar level. Additionally, a significant association between blood sugar monitoring and high blood sugar level has been shown (p=0.041), indicating that lack in daily blood sugar monitoring can increase the blood sugar level of a patient during Ramadan. Conclusion:The present study has helped in providing better understanding about the self-monitoring of blood glucose level and hypoglycemia. Furthermore, it also emphasizes the pre-Ramadan education about when to break their fasting along with frequency and timing of SMBG.
| S-EPMC7147609 | biostudies-literature
Project description:There is an emerging Muslim and diabetic population in the United States and other Western countries and majority of pregnant women and patients with diabetes mellitus choose to fast during Ramadan. Fasting during Ramadan in pregnant women with diabetes may represent a 'perfect storm' of metabolic disturbances including hyperglycemia, hypoglycemia and ketosis. Recent continuous and flash glucose monitoring data suggests increased glycemic variability (fasting hypo- and post-Iftar hyperglycemia) in non-pregnant patients with diabetes during Ramadan. Only five small-scale studies, predominantly focused on women with gestational diabetes mellitus in Muslim-majority nations have explored maternal glycemic outcomes during Ramadan which is associated with lower mean blood glucose levels and higher frequency of fasting hypoglycemia. Data is limited however on important clinical outcomes such as symptomatic and serious hypoglycemia requiring hospitalization. Results have been conflicting regarding maternal Ramadan fasting and association with fetal outcomes in women without diabetes. Only one recently published study reported on perinatal outcomes in pregnant women with gestational diabetes which found no effect of Ramadan exposure on mean birthweight or macrosomia frequency but lower neonatal hypoglycemia prevalence, however a significant limitation was lack of documentation of maternal fasting status. At this stage, due to paucity of data, the current medical recommendation is against Ramadan fasting for pregnant Muslim women with diabetes. Large-scale population-based studies are warranted regarding maternal and fetal outcomes in pregnant fasting women with diabetes and such studies should characterize maternal fasting status and have meaningful and consistent clinical outcomes. High-quality data derived from these studies can assist clinicians in providing more evidence-based advice to safely navigate both mother and fetus through a potentially challenging pregnancy.
| S-EPMC9263982 | biostudies-literature
Project description:ObjectiveFasting Ramadan is associated with changes in lifestyle patterns of patients with diabetes who choose to perform fasting. We aimed to determine the attitude and habits of patients with type 1 diabetes during fasting Ramadan.MethodsThe study comprised a prospective cohort of patients with type 1 diabetes who were on insulin pump or multiple daily insulin injections (MDI) regimen. Patient questionnaires included the frequency of self-monitoring of blood glucose (SMBG), the need to make changes in insulin regimen by patients, timings of insulin administration, performing carbohydrate counting and levels of physical activity.ResultsA total of 156 patients were studied (61 patients on insulin pump and 95 patients on MDI). Patients on pump therapy performed SMBG more frequently than those on MDI regimen (4.8 ± 1.4 and 3.7 ± 1.7 times per day, respectively, P = 0.001) and were more likely to perform carbohydrate counting (32.7% and 8.4% of pump and MDI patients, respectively, P < 0.001). There was no difference in the percentage of patients who made changes in insulin doses (74.5% of the pump group and 77.3% of MDI patients) or those who had any level of physical activity (12.5% of the pump group and 21.1% of the MDI group). The timing of administering meal insulin in relation to sunset meal was variable with a preference to taking the injection immediately at sunset. There was no difference in glucose control between both groups as measured by frucotsamine levels or the number of days that patients have to stop fasting.ConclusionFasting Ramadan is associated with significant and variable changes in the attitude and behaviors of patients with type 1 diabetes with no difference in glucose control between patients on insulin pump or MDI regimen. Further studies are needed to define the role of education and its effect on these attitudes and patient care in this population.ClinicalTrials.gov Identifier: NCT01941238.
| S-EPMC6169503 | biostudies-literature
Project description:The current study aimed to determine the effect of fasting during Ramadan on the metabolic profile, anthropometry, and serum leptin and adiponectin concentrations. Anthropometry and blood samples were examined at 2 phases: baseline (within 3 days of the start of the Ramadan fast) and end-line (in the last 3 days before the end of the Ramadan fast) in 27 healthy Muslim male participants who completed Ramadan fasting. Results demonstrate reductions in body weight (P < .001), body mass index (P < .001), fat mass (P = .003), muscle mass (P = .004), and waist circumference (P < .001) following reductions in energy intake (P = .003). Insulin sensitivity was improved. Serum insulin concentration and homeostatic model assessment of insulin resistance decreased significantly (P = .005 and P = .009). No significant change in fasting plasma glucose was observed. Correlation coefficients showed a significant correlation between the percentage changes in body weight and percentage changes in serum leptin concentration (r = 0.412; P = .037). These results demonstrate that intermittent fasting during Ramadan leads to beneficial effects by improving insulin sensitivity. It also resulted in a beneficial effect on weight and fat loss.
| S-EPMC7958211 | biostudies-literature
Project description:•After exclusion of pre-gestational diabetes, Asian Indian pregnant women have bimodal distribution of plasma glucose.•Bimodality is observed for fasting, 1 and 2 h post glucose load plasma glucose distribution.•Cut off values for gestational diabetes diagnosis could not identified for any glucose parameter.•In women with high gestational diabetes risk factors, the bimodality is evident before 24 weeks of gestation.•By third trimester, the bimodality is significant for all glucose parameters.
| S-EPMC6529712 | biostudies-literature
Project description:ObjectivesTo review and appraise the existing qualitative studies on Ramadan fasting in participants with diabetes and to integrate valuable qualitative evidence for optimizing diabetes management.MethodsTwelve databases (PubMed, Embase, Cochrane Library, Science Direct, CINAHL, PsycINFO, JBI (Joanna Briggs institute), Web of Science, and four Chinese databases) were searched to identify qualitative studies on experiences and perspectives of Ramadan fasting in participants with diabetes. CASP (Critical Appraisal Skills Program) Qualitative Checklists were applied to appraise the included studies. A meta-synthesis approach was used to analyze the included studies. Through the strategy of inductive thematic synthesis and reciprocal interpretation, the findings and quotations of the included studies were integrated into new themes and categories. The CERQual (Confidence in the Evidence from Reviews of Qualitative Research) tool was used to grade the confidence of the new themes.ResultsA total of 11 qualitative studies were included, and 43 findings were isolated. Ten new themes were identified and synthesized from the findings. Finally, four new categories were integrated, including the knowledge and understanding of observing Ramadan fasting, well-being and challenges, self-efficacy, and needs and expectations of participants with diabetes during Ramadan.ConclusionsInsulin-dependent individuals call for special concern during Ramadan fasting. Ramadan-focused education needs to be developed and generalized, and existing guidelines should be improved to optimize the management of diabetes. Professional HCPs contribute to weigh the health risks and mental satisfaction for their patients, partly, to balance health and religion. Participants' psychological construction is another concern for religious scholars and psychologists.
| S-EPMC7682869 | biostudies-literature
Project description: Not available
| S-EPMC11607719 | biostudies-literature
Project description:As of April 24, 2020, more than 1. 6 billion Muslims observe the holy fasting month of Ramadan worldwide. The safety of fasting of healthy adult Muslims during the COVID-19 era is debatable. In this perspective, we discuss the available scientific evidence of the advantages of fasting against COVID-19.
| S-EPMC7678565 | biostudies-literature
Project description:BackgroundDuring Ramadan fasting, postprandial hyperglycemia is commonly observed after iftar (break of fast at sunset) meal. D-allulose is a rare sugar and is reported to have several health benefits, including the suppression of increase in postprandial glucose levels. This study investigates whether D-allulose (a C-3 epimer of D-fructose) improves the postprandial glucose in patients with type 2 diabetes mellitus (T2DM) during Ramadan.MethodsThis was a pilot, prospective single-arm study design that was conducted for 10 consecutive days; 5 days of control and 5 days of consumption. The primary outcome was postprandial peak glucose levels. During the consumption period, 8.5 g of D-allulose was consumed by the participants before iftar meal. Postprandial glucose was measured using a continuous glucose monitoring system.ResultsA total of 12 participants completed the study. Significant lower (p < 0.01) postprandial glucose values and the glucose incremental area under the curve (iAUC) were observed from 0 to 180 min during the consumption period compared to the control period. The consumption period demonstrated significantly higher percentages of time in which glucose values were found in the target range (p = 0.0032), and when the glucose levels above the target range were reduced (p = 0.0015).ConclusionsThe supplementation with D-allulose has the potential to improve postprandial hyperglycemia in patients with T2DM after iftar during Ramadan. Further studies are needed to confirm these findings. Trial registration ClinicalTrials.gov NCT05071950. Retrospectively registered, 8 October 2021.
| S-EPMC9209837 | biostudies-literature
Project description: Not available
| S-EPMC7189168 | biostudies-literature