Cas clinique : Croyances, Ramadan et Diabète

Halimi, Serge; Lévy, Marc; Amghar, Hind

doi:10.1016/s0003-4266(04)96003-9

Cited by 9 publications

(6 citation statements)

References 16 publications

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“…This Ramadan-focused diabetes education needs to involve not just the health care team but also the patients’ families, friends, community, and religious authorities. It empowers patients to adapt their lifestyle and also helps them take responsibility for their care beyond the Ramadan fast [29, 31, 32]. In addition to these educational programs, newer pharmacologic agents with a reduced risk of hypoglycemia, such as DDP-4 inhibitors, may be a safer option for patients with diabetes during fasting [4, 11].…”

Section: Discussionmentioning

confidence: 99%

Experience with Vildagliptin in Type 2 Diabetic Patients Fasting During Ramadan in France: Insights from the VERDI Study

et al. 2013

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AimTo assess in real life the rate of hypoglycemia during Ramadan in patients with type 2 diabetes (T2DM) in France, according to their ongoing dual therapy of metformin-vildagliptin or metformin-sulfonylurea/glinide (IS).MethodsProspective, non-interventional study with 2 visits (within 8 weeks before and 6 weeks after the end of Ramadan 2012). Study diaries were not used to collect events or record values of glucose monitoring. One hundred and ninety-eight patients on stable oral dual therapy for ≥2 months and with glycosylated hemoglobin (HbA1c) ≤8.0% were recruited by 62 centers: 83 in the IS cohort and 115 in the vildagliptin cohort.ResultsApproximately 90% of patients were from Maghreb. The two cohorts were well balanced: 60% men, mean age 59 years, BMI 28 kg/m2, metformin dose ~2,000 mg/day, and HbA1c 7.2%. Distinct therapeutic management was planned in view of Ramadan with drug-adaptation intended in 61.4% of IS and 18.3% of vildagliptin patients. Hypoglycemia was reported in 37% of IS and 34% of vildagliptin patients; episodes declared as confirmed in 30.8% and 23.5%, respectively, and episodes documented as adverse event (AE) in 17.9% (22 episodes) and 7.5% (13 episodes), respectively (P = 0.025). Severe episodes were reported in 3.9% of IS and 1.7% of vildagliptin patients. 10.4% of IS and 2.6% of vildagliptin patients reported severe episodes and/or unscheduled medical visits due to hypoglycemia (P = 0.029). Glycemic control remained stable in both cohorts. Compliance with fasting was high, as well as adherence to drug with ≥5 missed-dose for 15.4% of IS and 8.5% of vildagliptin patients.ConclusionAlthough the overall frequency of malaise suggestive of hypoglycemia was high, which would be expected with prolonged fasting in a well-controlled T2DM population during hot summer days, the incidence of more severe and better-documented episodes (AE, severe event, event leading to unscheduled medical visit) were much lower, with consistently less events with vildagliptin therapy.

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Section: Discussionmentioning

confidence: 99%

Experience with Vildagliptin in Type 2 Diabetic Patients Fasting During Ramadan in France: Insights from the VERDI Study

et al. 2013

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“…So to eat or not to eat, share or not to share that is the usual dilemma for diabetic persons during Ramadan! But, eating and sharing, which means inadequate behavior for the diabetic people,[ 24 ] usually worsen glucose control with a high risk of complications and infections. For this, hospitalizations for ketoacidosis, hyperosmolar coma and diabetes foot increase during Ramadan.…”

Section: A Lgerian D Iabetic P mentioning

confidence: 99%

Diabetes mellitus and Ramadan in Algeria

Chentli

Azzoug

Amani

et al. 2013

Indian J Endocr Metab

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Ramadan, one of the five pillars of Islam, is a holy month in Algeria where diabetes mellitus (DM) is more frequent in urban areas with a frequency which varies from 8 to 16%. DM complications are broadly as frequent as in developed countries, except for neuropathy which seems more frequent. Despite contraindications which are regularly explained to our patients and despite the flexible side of Islam toward chronic diseases, most Algerian people with DM insist on fasting. Not fasting is considered a sin and shameful. There are also other reasons put forward by diabetic persons, such as very strong religious faith, habit of fasting together with the whole family since an early age, solidarity with the family, friends, and neighbors, and finally and probably because of the desire to appear “normal” and share a festive and a spiritual atmosphere of Ramadan. As in other Muslim countries, severe hypoglycemia the main motive of hospitalizations during the holy month, ketoacidosis, dehydration, orthostatic hypotension and thrombosis are some of the complications which Algerian people with DM are exposed to when fasting.

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“…In the literature, the variation of certain biochemical and clinical parameters, significant or not, contradicted, has been reported in relation to the effect of fasting in diabetics. The study results of Ouhdouch et al ( 52 ) and of Abdessadek et al ( 53 ) reported a significant decrease in HbA1c, while the opposite was noted in the study of Halimi et al ( 54 ) and of Mbainguinam et al ( 55 ) explaining this inequality of HbA1c would be the cause of hypertriglyceridemia. Also, an improvement in the lipid profile ( 53 , 56 , 57 ) was found, a significant decrease in fasting blood glucose during Ramadan compared to outside ( 53 , 57 , 58 ), hyperglycaemic episodes with or without ketoacidosis and severe hypoglycaemia ( 59 – 61 ), the presence of higher hypoglycemia in patients treated with insulin ( p = 0.002), followed by those treated with oral agents including sulfonylureas as compared to oral agents excluding sulfonylureas ( 57 ).…”

Section: Fasting Metabolic Changes Complications and Clinical Aspectsmentioning

confidence: 89%

Ramadan Fasting and NCDs-Example of the Diabetes

et al. 2022

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Although Ramadan lasts only for 1 month each year, it can be accompanied by significant changes in: both energy and nutritional intake; in the diet composition; in the working hours; and the usual way of life. The majority of practitioners consume two meals, one after sunset (Iftar) and one before dawn (Sohor). During this month, it is also an opportunity to share a meal with family and friends, a period of highly intensified socialization. In parallel with the nutritional changes brought about by this unique pattern of fasting in Ramadan, other metabolic and physiological changes may occur, such as fluctuations in body weight and/or disturbance in the quantity and quality of the sleep-wake circadian rhythm. In the verses of the Qur'an, the exemption from fasting in certain situations such as illness is clearly stated. Despite this religious tolerance, many faithful who are eligible for the exemption observe the fast of Ramadan either for the spiritual aspect it provides by performing it, by religious guilt or to mark a normalization in the Muslim community for fear of the gaze of others. The world is experiencing an increase in the emergence of non-communicable diseases (NCDs); leading cause of the global mortality. Environmental and behavioral risk factors related to lifestyle, such as smoking, excessive alcohol consumption, unhealthy diet, and sedentarity have a causal association with NCDs. Other factors, such as genetic and physiological factors may also be associated (overweight, high blood pressure, dyslipidemia). Diabetes is one of the highest prevalent NCDs in the world and it continues increasing year by year. This chronic disease can lead to significant potential complications (degenerative, dermatological, and acute) to the patient's health. This requires an individual and appropriate care, both dietetic and therapeutic and over the long term will at best make it possible to sensitize the diabetic patient to the adverse effects related to his disease and thus improve its quality of life. Performing the Fast of Ramadan for a diabetic is a common situation. Diabetes is the only chronic disease widely studied in relation to Ramadan fasting. In the literature, many studies have investigated the effects of Ramadan intermittent fasting on diabetic patients. This article aims to provide a general overview and highlight if there are many effect of Ramadan fasting on diabetes, as an example of a NCDs.

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Cas clinique : Croyances, Ramadan et Diabète

Cited by 9 publications

References 16 publications

Experience with Vildagliptin in Type 2 Diabetic Patients Fasting During Ramadan in France: Insights from the VERDI Study

Experience with Vildagliptin in Type 2 Diabetic Patients Fasting During Ramadan in France: Insights from the VERDI Study

Diabetes mellitus and Ramadan in Algeria

Ramadan Fasting and NCDs-Example of the Diabetes

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