Biometric and metabolic changes in patients with diabetes prior, during and after the holy month of Ramadan (ABCD Study)
تغییرات بیومتریک و متابولیک در بیماران مبتلا به دیابت قبل ، در و پس از ماه مبارک رمضان (مطالعه ABCD)-2021
Physiological impact of the intermittent or prolonged fasting is known from various studies on healthy subjects. However, data on impact of fasting on biochemical and biometric parameters in people with diabetes is building up. Safety of Ramadan fasting has always been assessed after Ramadan. This study looked into the immediate effect of fasting during the fasting days compared to time before and after the fasting month. Methods: This is an observational study. We looked into people with biometric and biochemical records before Ramadan, and we followed them up during and after Ramadan prospectively. We were aiming for assessing the biochemical and biometric changes for people with diabetes during Ramadan in comparison to pre-and post Ramadan. As well as the differences between these measures according to type and treatment of diabetes in those who fasted as well as in those who did not fast during Ramadan. Results: Total of 342 patients were recruited to the study. All were patients with diabetes at a mild to moderate risk of complications if fasted. Majority were males 52.3% (n = 180), while females were 47.7% (n = 162). Most of the results showed a U shape between Pre-Ramadan, During Ramadan and Post-Ramadan periods. there was a modest but significant reduction in weight but regained after Ramadan. Conclusions: Our study suggests that for many people with diabetes fasting is not associated with an increased risk to their glycemic control, their weight and/or their blood pressure. Indeed, what is seen is marginal benefit or no change in all parameters. This stratifies the ongoing recommendation that allows patients with categorized as low risk to fast Ramadan or non-Ramadan days whenever desired.
Keywords: Diabetes and Ramadan | Diabetes | Fasting | Low risk | Biochemical changes in Ramadan
Knowledge gaps and perceptions of future research directions on management of diabetes during Ramadan fasting: An online survey of physicians
شکاف های دانش و درک دستورالعمل های تحقیقاتی آینده در مدیریت دیابت در طول روزهداری ماه رمضان: مرور آنلاین پزشکان-2021
Objectives: Current knowledge and research on diabetes and Ramadan form the basis for evidence-based clinical practice. In this context, we aimed to explore physicians’ perceptions of current knowledge gaps about research fasting (RF), barriers to, and foreseeable directions for advancement of the field.
Methods: We conducted an online survey of a convenience sample of 260 physicians from 27 countries. The survey questionnaire addressed three main domains: perceived current knowledge gaps and unmet needs in research about RF and diabetes, barriers to the conduct of research, and future directions for furthering the evidence in this field.
Results: Majority of respondents (65.7%) were senior physicians in adult endocrinology/diabetes (45.9%) working at tertiary centers (65.2%). The majority (67.3%) reported seeing an average of 20+ patients with diabetes weekly and felt ‘‘very or fairly confident” in managing diabetes during RF (67.7%). The knowledge gaps identified were the management of highrisk patients with diabetes (54.1%), such as renal impairment (59.8%), and pregnancy (61.5%). The main barriers to research were lack of adequate funding to academic centers (75.7%) and lack of interest of institutions in the subject (64.6%). Future efforts should be directed at the conduct of large epidemiological studies (49.5%) or double-blinded, placebo-controlled clinical trials (48.6%) to address the former gaps. Research findings should be widely disseminated via hands-on workshops (recommended by 70.3% of respondents) or international conferences (61.2%).
Conclusions: There is a wide agreement regarding the knowledge gaps in the management of diabetes during RF. Future efforts should focus on addressing these critical deficiencies.
keywords: روزه رمضان | ادبیات | دیابت | هیپوگلیسمی | همهگیرشناسی | کتواسیدوز دیابتی | دیدگاه های بیماران | متخصصان مراقبت های بهداشتی | ادراک | بیماران پر خطر | کودکان و نوجوانان | Ramadan fasting | Literature | Diabetes | Hypoglycaemia | Epidemiology | Diabetic ketoacidosis | Patients’ perspectives | Health Care Professionals | perceptions | High-risk patients | Children and adolescents