Higher rate of hyperglycemia than hypoglycemia during Ramadan fasting in patients with uncontrolled type 1 diabetes: Insight from continuous glucose monitoring system.
Saudi Pharm J
; 26(7): 965-969, 2018 Nov.
Article
en En
| MEDLINE
| ID: mdl-30416354
ABSTRACT
BACKGROUND:
Patients with uncontrolled type 1 diabetes mellitus (T1DM) are at a high risk for Ramadan fasting and are exempt from fasting; however, most still insist on fasting. The aim of this study was to examine glucose level fluctuations in those patients during Ramadan fasting using a real-time continuous glucose monitoring system (RT-CGMS).METHODS:
This pilot study involved adult patients with uncontrolled T1DM (HbA1câ¯>â¯7%) who insisted on fasting during Ramadan in 2014 from Maternity and Children's Hospital, Medina, Saudi Arabia. A Medtronic RT-CGMS was used to monitor the participants' glucose levels for 3 consecutive days during fasting.RESULTS:
The study included 22 patients (mean age 22⯱â¯6â¯years, duration of diabetes 10.9⯱â¯7.2â¯years, HbA1c level 9.3⯱â¯1.2). All participants were using the basal-bolus insulin regimen, except for one patient who was on an insulin pump. Sensor glucose (SG) profiles typically followed a pattern that was characterized by an exaggerated increase after iftar, which was sustained overnight, and a second rapid rise after suhoor, with a prolonged glucose decay over the daylight hours. The average SG was 199⯱â¯104.1â¯mg/dl, which was lower during fasting 188.4⯱â¯103.41â¯mg/dl than during the eating hours 212.5⯱â¯103.51â¯mg/dl (Pâ¯=â¯0.00). There was a higher rate of hyperglycemia (48%) than hypoglycemia (10%).CONCLUSIONS:
Patients with uncontrolled T1DM who fasted during Ramadan experienced a wide fluctuation of glucose levels between fasting and eating hours, exhibiting a greater tendency toward hyperglycemia. The long-term effects for this finding are not known and warrant further investigation.
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MEDLINE
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Año:
2018
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Article