The impact of fasting during Ramadan on the glycemic control of patients with type 2 diabetes mellitus.

BACKGROUND: Millions of Muslims fast from dawn until dusk during the annual Islamic holy month of Ramadan. Most of the studies evaluating biochemical changes in diabetic patients during Ramadan showed little changes in the glycemic control. In this study, our aim was to assess the impact of fasting during Ramadan on glycemic control in patients with type 2 diabetes. METHODS AND DESIGN: We examined 122 patients with type 2 diabetes (82 female, 40 male, age 56.93 ± 9.57 years) before and after the Ramadan. 66.4% of the patients were treated with oral antidiabetic (OAD) alone, 6.5% with a combination of insulin plus OAD and 19.7% with insulin alone. 88 of 122 patients fasted during Ramadan (26.98 ± 5.93 days). Weight, body mass index (BMI), waist circumference, blood pressure, fasting plasma glucose (FPG), postprandial glucose (PPG), fructosamine, HbA1c, fasting insulin and lipid parameters were measured. RESULTS: The frequencies of both severe hyperglycemia and hypoglycemia were higher in the fasting group, but the difference was not significant (p=0.18). Weight, BMI, waist circumference, blood pressure, FPG (143.38 ± 52.04 vs. 139.31 ± 43.47 mg/dl) PPG (213.40 ± 98.56 vs. 215.66+109.31 mg/dl), fructosamine (314.18 ± 75.40 vs. 314.49 ± 68.36 µmol/l), HbA1c (6.33 ± 0.98 vs. 6.22 ± 0.92%) and fasting insulin (12.61 ± 8.94 vs. 10.51 ± 6.26 µU/ml) were unchanged in patients who fasted during Ramadan. Microalbuminuria significantly decreased during Ramadan (132.85 ± 197.11 vs. 45.03 ± 73.11 mg/dl). CONCLUSIONS: In this study, we concluded that fasting during Ramadan did not worsen the glycemic control of patients with type 2 diabetes.

Quantifying submarine groundwater discharge in the coastal zone via multiple methods.

Submarine groundwater discharge (SGD) is now recognized as an important pathway between land and sea. As such, this flow may contribute to the biogeochemical and other marine budgets of near-shore waters. These discharges typically display significant spatial and temporal variability making assessments difficult. Groundwater seepage is patchy, diffuse, temporally variable, and may involve multiple aquifers. Thus, the measurement of its magnitude and associated chemical fluxes is a challenging enterprise. A joint project of UNESCO and the International Atomic Energy Agency (IAEA) has examined several methods of SGD assessment and carried out a series of five intercomparison experiments in different hydrogeologic environments (coastal plain, karst, glacial till, fractured crystalline rock, and volcanic terrains). This report reviews the scientific and management significance of SGD, measurement approaches, and the results of the intercomparison experiments. We conclude that while the process is essentially ubiquitous in coastal areas, the assessment of its magnitude at any one location is subject to enough variability that measurements should be made by a variety of techniques and over large enough spatial and temporal scales to capture the majority of these changing conditions. We feel that all the measurement techniques described here are valid although they each have their own advantages and disadvantages. It is recommended that multiple approaches be applied whenever possible. In addition, a continuing effort is required in order to capture long-period tidal fluctuations, storm effects, and seasonal variations.