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Prediabetes is common in patients presenting with ACS who are not previously known to have diabetes. Prediabetic patients had worse in-hospital clinical outcomes compared with patients without diabetes.

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Background All healthy, adult Muslims are obligated to fast from sunrise to sunset for one lunar month each year. During this time, they have to abstain from food, water, beverages, smoking, oral drugs and sexual intercourse. A large multicentred, epidemiological study in 13 Muslim countries also revealed that 43% of people with Type 1 diabetes and 86% of people with Type 2 diabetes observed the fast during Ramadan. Previously, an education programme in London has attempted to provide advice and support locally to Muslim patients with diabetes, who choose to fast during the month of Ramadan. Objective Safety & efficacy of diabetes health education programs in Ramadan fasting in people with T1DM. Methods The study was conducted on 60 Type 1 diabetic patients intended to fast Ramadan 2017 with average fasting hours 16 hrs. The patients were recruited form the Diabetes outpatient clinic at Ain-Sham University hospitals. All participants (60 subjects) received a basic health education program which was based on Conversational MAP (Living with diabetes). Then participants were subdivided into 2 equal groups each of 30 subjects: Group 1 received Modified IDF health education program for Ramadan fasting. Group 2 received Ramadan Conversational MAPS. Only 29 patients in group 1 and 24 patients in group 2 completed the study, while other 7 patients who attended pre-Ramadan health education sessions but were lost to follow up sessions during and after Ramadan, so they were excluded from the study. Conclusion Health education make Ramadan fasting more safe in those patients with type-I diabetes whatever the method of education. Results Speaking of effect of health education programs on safe Ramadan fasting, glycemic control & less frequent hypoglycemic episodes sһowed significant decrease in FBS before and after Ramadan in both study groups witһ a mean difference in FBS are 24.517 mg/dl and 61.833mg/dl IDF & MAPS groups respectively .

Background Diabetes is a complex, chronic illness requiring continuous medical care with multifactorial risk-reduction strategies beyond glycemic control. Ongoing patient self-management education and support are critical to preventing acute complications and reducing the risk of long-term complications. Significant evidence exists that supports a range of interventions to improve diabetes outcomes. Objective This study aimed to demonstrate the impact of fasting on primarily on ẻGFR & microalbuminuria in people with type 1 diabetes and secondarily on neuropathy & retinopathy. It was conducted on 60 patients with T1DM. All patients underwent full history taking, full clinical examination and biochemical tests including FBG, 2h PPBG, HbA1c, fructosamine, s.creatinine, BUN, uACR, eGFR, fundus examination and DN4 Q. Methods This study was conducted on 60 type 1 diabetic patients with microalbuminuria intending to fast Ramadan. Patients were recruited from internal medicine and diabetes clinics of Ain Shams University. The study performed health education 2 months prior to Ramadan 1438 (2017) with follow up throughout the month and after Ramadan. The patients were on basal-bolus regimen, 36 were on lantus, 17 were on NPH and the remaining 7 patients didnot complete the follow up after Ramadan for family reasons. Results There had been significant difference between pre and post-fasting as regards weight and BMI, and non significant difference regards waist circumference. Also highly significant difference between basal and bolus doses before and during Ramadan. There had been no significant difference between pre and post Ramadan regarding fundus examination, systolic and diastolic blood pressure and a significant difference regarding DN4 Q. Regarding no. of successful fasting days and attacks of hypoglycemia, a significant difference was found. Significant difference in FBS, 2hr PPBG, BUN, s.creatinine, uACR and eGFR, and fructosamine. There was a significant positive correlation between eGFR and height, weight before Ramadan and between eGFR and height, weight after Ramadan, no. of successful fasting days Ramadan 2017. Also a significant negative correlation was shown between eGFR and A / C ratio, Cr, BUN before Ramadan and between éGFR and Cr, BUN after Ramadan. Height, BUN before and after Ramadan and A / C ratio before Ramadan were found to be independent predictors of eGFR. Conclusion Ramadan fasting appears to have significant impact on microvascular complications of type 1 DM patients. These impacts can be attributed to many factors as physical sloth, change of time and pattern of feeding, climate conditions at time of fasting especially hot humid weather predisposing to more frequent dehydration with its sequelae as well as non-compliance of some patients to the proper lifestyle, diet and medications.

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