Diabetes During the Fasting Month of Ramadan: Is Telemedicine as Efficient as Conventional Follow-Up? Results from a Moroccan Comparative Study.

AIM: During the COVID-19 pandemic, access to health care was affected by the lockdown period. To overcome this situation, telemedicine is an alternative to conventional follow-up for patients with diabetes during the fasting month of Ramadan. The aim of this study is to compare the effectiveness of telemedicine consultation of diabetic patients during Ramadan compared with conventional follow-up. METHODS: This comparative cross-sectional study conducted in the Sheikh Khalifa Ibn Zaid Hospital of Casablanca, Morocco, included diabetic patients followed up by conventional consultation in 2019 Ramadan and by telemedicine in 2020 Ramadan. For each patient and in both Ramadans (2019 and 2020), we have conducted a pre-Ramadan assessment, screening for acute diabetic complications during Ramadan and an evaluation of weight and glycated hemoglobin of patients, after Ramadan. We compared the occurrence of acute complications and the variation of metabolic parameters of patients in Ramadan 2020 with their results in Ramadan 2019. RESULTS: In this study, we included 61 patients. In Ramadan 2020, compared with Ramadan 2019, there was no significant difference in terms of hypoglycemia (18.03% versus 32.78%, p = 0.09), minor hyperglycemia (13.1% versus 11.47%, p = 0.35) and major hyperglycemia or ketoacidosis (3.27% versus 6.55%, p = 0.19). Fasting was interrupted in 8.19% versus 11.47% (p = 0.012). There were no significant variations of weight (+0.62 versus -0.77; p = 0.09). In term of variation of glycated hemoglobin, there was a significant different between Ramadan 2020 and Ramadan 2019 (-0.36 versus -0.61 in 2019, p<0.05). CONCLUSION: Despite comparable results in terms of weight change and hypoglycemia, our study showed that telemedicine follow-up in patients with diabetes during Ramadan did not provide as effective glycemic control as conventional monitoring.

Pituitary Apoplexy in Geriatric Patients: A Report of Four Cases.

Pituitary apoplexy (PA) is a rare clinical syndrome related to abrupt hemorrhage and/or infarction of the pituitary gland, usually occurring in patients with preexisting pituitary disease. It is an endocrine emergency requiring rapid diagnosis and appropriate management. This is a literature review and a retrospective study reporting the observation of four patients that have suffered from pituitary macroadenomas. These observations illustrate the particularities of this pathology in the elderly. The symptoms may be truncated and lead to a late diagnosis with its repercussions on management, without forgetting the particularity of the fragile and multisystemic terrain, which may contraindicate the usual surgical treatment. A rapid diagnosis and appropriate management can limit the occurrence of irreversible complications.