Guidelines for managing diabetes in Ramadan

Ali, Samina; Davies, Melanie J.; Brady, Emer M; Gray, Laura J.; Khunti, Kamlesh; Beshyah, Salem A.; Hanif, Wasim

doi:10.1111/dme.13080

Cited by 81 publications

(72 citation statements)

References 38 publications

(60 reference statements)

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“…2,9 The Diabetes and Ramadan International Alliance (DAR) have published guidelines which provide clear guidance for health professionals and patients on the safety of fasting and changes in medication recommended for patients planning to fast. 1 The guidance states that patients at very high risk or high risk should be discouraged from fasting but that, if they insist, they should receive structured education and careful monitoring by the diabetes specialist team, monitor blood glucose regularly, adjust medication as per recommendations and be prepared to stop the fast if hypoglycaemia (glucose <3.9 mmol/L) or hyperglycaemia (glucose >16.7 mmol/L) occurs.…”

Section: Discussionmentioning

confidence: 99%

“…1 A number of guidelines exist to enable health professionals to advise Muslim patients on their risk of fasting, and how to manage their diet and diabetes medication whilst fasting. 1,2 Previous studies have looked at outcomes of fasting in patients predominantly in tropical climates where the duration of fasting is generally stable at around 12-14 hours. 3,4 In this study, we aimed to survey Muslim patients with diabetes in East London on their experience of fasting during summer 2016, a period when the duration of fasting was over 19 hours.…”

Section: Introductionmentioning

confidence: 99%

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A survey of patients with type 2 diabetes and fasting outcomes during Ramadan 2016 in London: the East London Diabetes in Ramadan Survey

Chowdhury

2017

Br J Diabetes

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Aims: Fasting in the summer months for Muslim people with diabetes during Ramadan is challenging, particularly in temperate climates where the duration of fasting is prolonged. We aimed to survey the experiences of patients with diabetes during Ramadan 2016 in East London. Methods: A telephone survey of Muslim patients with type 2 diabetes in Tower Hamlets, London was carried out. Patients were surveyed on discussions with a health professional before Ramadan, whether they followed advice given, the number of fasts undertaken, alterations in medication and adverse events. Results: Of 1,000 people contacted, 718 agreed to the survey. 396 (55.1%) were female, the median age was 52.1 years (range 31-84) and median diabetes duration 13.6 years (range 1-45). 36 (5%) were treated with diet alone, 428 (59.6%) with oral antidiabetic therapy and 254 (35.4%) were treated with insulin. 372 people (52%) discussed fasting with a health professional; 126 (33.8%) were advised not to fast, of whom 103 (81.7%) elected not to fast. 398 (55.4%) fasted at least once; the median number of days fasted was 16 (range 1-30). 327 patients (82.1%) made changes to their therapy. 24 patients (6%) reported episodes of hypoglycaemia, of whom two (0.3%) required third party assistance. Conclusions: Significant numbers of patients did not discuss fasting with a health professional prior to Ramadan and some patients fasted despite medical advice. Despite the long duration, many patients fasted successfully for at least part of Ramadan, with few adverse outcomes. Br J Diabetes 2017;17:149-151

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A survey of patients with type 2 diabetes and fasting outcomes during Ramadan 2016 in London: the East London Diabetes in Ramadan Survey

Chowdhury

2017

Br J Diabetes

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“…Type 2 diabetes mellitus is one of the most frequently encountered metabolic syndromes worldwide. The most recent meta‐analysis showed that the overall prevalence (9.1%) has been increasing among inland residents in China since the 1970s, and it increased rapidly with age.…”

Section: Introductionmentioning

confidence: 99%

Effects of yoga in adults with type 2 diabetes mellitus: A meta‐analysis

Cui

Yan

et al. 2016

J of Diabetes Invest

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Aims/IntroductionA meta‐analysis was carried out to evaluate the efficacy of yoga in adults with type 2 diabetes mellitus.Materials and MethodsThe PubMed, EMBASE and Cochrane databases were searched to obtain eligible randomized controlled trials. The primary outcome was fasting blood glucose, and the secondary outcomes included glycosylated hemoglobin A1c, total cholesterol, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, triglyceride and postprandial blood glucose. Weighted mean differences and 95% confidence intervals (CIs) were calculated. The I 2 statistic represented heterogeneity.ResultsA total of 12 randomized controlled trials with a total of 864 patients met the inclusion criteria. The pooled weighted mean differences were −23.72 mg/dL (95% CI −37.78 to −9.65; P = 0.001; I 2 = 82%) for fasting blood glucose and −0.47% (95% CI −0.87 to −0.07; P = 0.02; I 2 = 82%) for hemoglobin A1c. The weighted mean differences were −17.38 mg/dL (95% CI −27.88 to −6.89; P = 0.001; I 2 = 0%) for postprandial blood glucose, −18.50 mg/dL (95% CI −29.88 to −7.11; P = 0.001; I 2 = 75%) for total cholesterol, 4.30 mg/dL (95% CI 3.25 to 5.36; P < 0.00001; I 2 = 10%) for high‐density lipoprotein cholesterol, −12.95 mg/dL (95% CI −18.84 to −7.06; P < 0.0001; I 2 = 37%) for low‐density lipoprotein cholesterol and −12.57 mg/dL (95% CI −29.91 to 4.76; P = 0.16; I 2 = 48%) for triglycerides.ConclusionsThe available evidence suggests that yoga benefits adult patients with type 2 diabetes mellitus. However, considering the limited methodology and the potential heterogeneity, further studies are necessary to support our findings and investigate the long‐term effects of yoga in type 2 diabetes mellitus patients.

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“…Ramadan occurred during the second period (between M 3 and M 6 ) and may have interfered with glycaemic control because of modifications in nutritional habits 13. However, the period between inclusion and M 3 was chosen so that there was no interference with the primary end point.…”

Section: Discussionmentioning

confidence: 99%

SMS-based intervention in type 2 diabetes: clinical trial in Senegal

Wargny¹,

Kleinebreil²,

Diop³

et al. 2018

BMJ Innov

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ObjectiveSince 2014 Senegal has benefited from regular awareness-raising Short Message Service (SMS) campaigns (Be He@lthy, Be Mobile initiative) directed at people who have signed up, for free, to the ‘mDiabète’ programme. We report on an evaluation of its impact on diabetes control.DesignThe clinical trial was designed to send daily SMS during 3 months to people with type 2 diabetes. Due to centre randomisation, SMS were sent from inclusion (M0) to month 3 (M3) to people in centre S and from M3 to month 6 (M6) to people in centre P.SettingMedical centre S in the northwestern suburbs of Dakar; centre P in Popenguine, 70 km south of Dakar.ParticipantsIn February 2017, people with type 2 diabetes were consecutively recruited in the two centres. Complete data were available from 186 of these people.Main outcome measuresHbA1c was measured in the two centres with the same assay throughout the study. The primary end point was the difference between centres for the change in HbA1c from M0 to M3. Secondary end points were the evolution of HbA1c in centres S and P between M3 and M6.ResultsThe HbA1c change from M0 to M3 in centre S was better than in centre P, with a median difference of −0.4%, quartiles (−1.0; 0.3) versus 0.2% (-0.5; 0.8), respectively (p=0.0038). HbA1c decreased over the 3 months after having stopped SMS in centre S and was confirmed in centre P. The campaign cost was €2.5 (US$3.1) per person.ConclusionsIn Senegal, SMS sending was associated with an improved glycaemic control in people with type 2 diabetes. As SMS has a high penetration in low-income, middle-income countries where medical resources are scarce, health interventions using mobile telephones should be developed to facilitate exchanges between people with diabetes and medical teams; this may reduce diabetes-related complications.

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Guidelines for managing diabetes in Ramadan

Abstract: Up to date guidelines for the management of treatment regimes are set-out for those with Type 1 and Type 2 diabetes who wish to fast during Ramadan.

Cited by 81 publications

References 38 publications

A survey of patients with type 2 diabetes and fasting outcomes during Ramadan 2016 in London: the East London Diabetes in Ramadan Survey

A survey of patients with type 2 diabetes and fasting outcomes during Ramadan 2016 in London: the East London Diabetes in Ramadan Survey

Effects of yoga in adults with type 2 diabetes mellitus: A meta‐analysis

SMS-based intervention in type 2 diabetes: clinical trial in Senegal

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