Observational Study of the Tunisian Diabetic Patients' Profile during the Fasting of the Holy Month of Ramadan Article Swipe
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· 2016
· Open Access
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· DOI: https://doi.org/10.15226/2374-6890/3/4/00158
· OA: W2590848419
Aims:To analyze the profile of patients with Type 1 Diabete Mellitus (T1DM) and Type 2 Diabetes Mellitus (T2DM) fasting during Ramadan.Methods: Descriptive observational epidemiological study in T1DM and T2DM diabetes treated by insulin and or oral antidiabetic drugs, older than 20 years old and who made their own decision to fast.Patients were recruited 1 to 30 days before Ramadan and followed-up up to 30 to 40 days after.Results: 533 patients were included, 29 (5.4%) were T1DM.The median age was 43.5 years for type1 and 54.6 years for type2.The mean duration of diabetes was 8.47 years.32% of type 2 diabetes were treated with insulin.Seven percent of type 2 patients stopped fasting at mid-Ramadan and six percent at the end of Ramadan.In T1DM (11,1% and 0%) stopped fasting at mid-Ramadan and at the end of Ramadan respectively.The main cause for stopping fasting was hypoglycemia.The number of hypoglycemia in type2 remained stable between before Ramadan vs. mid-Ramadan (0.2 vs 0.3).However it decreased significantly to 0.1 at the end of Ramadan.No significant changes were noticed for type 1.We noted no increase of severe and nocturnal hypoglycemia.In the whole population, 27.6% had normal blood glucose ≤ 1.26 g/ l before Ramadan vs 32.4% at mid Ramadan, and 35.9% at the end of Ramadan (p = 0.008).No significant difference for A1c between before Ramadan and at the end of the study.We noted a change of lifestyle during this month with a tendency to the reduction of the physical-activity and an increase in liquid ingestion at the beginning of Ramadan.Calories and carbohydrate intake were both lower during the 2nd half of Ramadan for type 2 patients vs the first half.Weight remained stable during Ramadan and throughout the study.Approximately 24% of the patients adapted their treatment at the beginning of Ramadan mainly by dose ranging decrease. Conclusion:Glycemic control was acceptable during Ramadan due to a change in lifestyle and attitudes of patients with regards to fasting.Hypoglycemia episodes increased during the first half and decreased significantly during the second half of Ramadan.
