The risk for hypoglycemia during Ramadan fasting in patients with adrenal insufficiency

Chihaoui, Mélika; Grira, W.; Bettaieb, Jihéne; Yazidi, Mériem; Chaker, Fatma; Rejeb, Ons; Oueslati, I.; Feki, Moncef; Kaabachi, Naziha; Slimane, H.

doi:10.1016/j.nut.2017.07.014

Cited by 13 publications

(8 citation statements)

References 20 publications

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“…Non-diabetic patients having various disorders such as hepatic, renal, or cardiac failure, together with seemingly-well individuals with endogenous hyperinsulinism due to multiple causes, and those with hormonal deficiencies are at risk for developing hypoglycemia. Chihaoui et al, in their prospective study on adult patients with adrenal insufficiency who were fasting in Ramadan, reported that their interstitial glucose levels were lower than normal and asymptomatic hypoglycemia was present in some of them (10). In our study, there were nondiabetic patients who were presented with hypoglycemia; however, the number of non-diabetic hypoglycemic individuals was minimal.…”

Section: Discussioncontrasting

confidence: 51%

Analysis of Emergency Department Admissions with Hypo or Hyperglycemia in the Month of Ramadan

Gürmen

Özlüer

Doğan

et al. 2021

Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi

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Bu çalışma ile Ramazan ayında acil servise başvuran diyabetik hastaların glisemik profilinin ortaya konulması amaçlandı. Acil servise hipo veya hiperglisemi ile başvuran ve oruç tuttuğunu ifade eden, 18 yaş üstü hastaların dosyaları geriye dönük olarak incelendi. Çalışmaya 161 (%95.3)'i hiperglisemi, 8 (%4.7)'i hipoglisemi nedeniyle başvuran toplam 169 (139 diyabetik, 30 diyabeti olmayan) hasta dahil edildi. Hastaların kan glukoz düzeyi 36 mg/dl ile 736 mg/dl arasında değişirken, ortalama 279±127 mg/dl olarak hesaplandı. 163 (%96.4) hastanın acil servisten taburcu edildiği, 4 (%2.4) vakanın sevk edildiği ve sadece 2 (%1.2) hastanın hastaneye yatırıldığı görüldü. Ramazan ayında ortaya çıkabilecek metabolik bozukluklar ve semptomlarının titiz takibi ile bilgilendirildikten sonra, diyabetik hastaların herhangi bir ekstra diyet ve ilaç protokolü izlemeden oruç tutabilecekleri görülmektedir. Diyabeti olmayan kişilerde de Ramazan ayında hipo veya hiperglisemi atağı görülebilir. Bu hastaların özellikle prediyabetik durum ve hipo veya hiperglisemiyi tetikleyebilecek altta yatan hastalıklar açısından tetkik edilmesi gereklidir.In this study, we aimed to identify the glycemic profile of patients admitted to our emergency department during Ramadan. The charts of patients aged 18 years and over who had been fasting religiously and admitted to the Emergency Service with hyperglycemia or hypoglycemia during the month of Ramadan, were reviewed retrospectively. 169 patients (30 non-diabetic, 139 diabetic) were found to be admitted with hyperglycemia (161 cases, 95.3%) or hypoglycemia (8 cases, 4.7%). The blood glucose level ranged from 30 to 736, with an mean of 279±127 mg/dl. 163 cases (96.4%) were discharged from the hospital, 4 cases (2.4%) were referred to another hospital, and only 2 cases (1.2%) were hospitalized. After being informed about the metabolic disturbances that might occur during Ramadan and by meticulous follow-up of their symptoms, there is no harm in terms of urgent complications in the religious fasting of diabetes mellitus patients without complying any extra diet or medication protocol. Non-Diabetic patient scan undergo episodes of hypo or hyperglycemia during Ramadan. Such patients should be investigated for the presence of a prediabetic status or an underlying disease that can trigger a hyper or hypoglycemic episode.

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Section: Discussioncontrasting

confidence: 51%

Analysis of Emergency Department Admissions with Hypo or Hyperglycemia in the Month of Ramadan

Gürmen

Özlüer

Doğan

et al. 2021

Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi

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“…However, patients undergoing a fasting must have a full knowledge of their condition. For example, patients with adrenal insufficiency should be treated with Chronocort, Plenadren or others for preventing eventual complications (45).…”

Section: Discussionmentioning

confidence: 99%

Intermittent fasting therapy promotes insulin sensitivity by inhibiting NLRP3 inflammasome in rat model

et al. 2021

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Background: Substantial studies have demonstrated that fasting therapy (FT) can inhibit the inflammatory response and improve insulin resistance (IR); however, the underlying mechanisms are still unclear. This study aimed to explore the related mechanisms of intermittent FT for the treatment of IR.Methods: A rat IR model was established through collaboration of a high-fat diet with streptozotocin (STZ) injection. 8 rats were treated with intermittent FT. A positive control group was treated with metformin (MET). Mouse 3T3-L1 pre-adipocytes were cultured and induced into adipocytes in vitro, and were used as the cellular IR model. Blood insulin, glucose, and homeostatic model assessment (HOMA)-IR index were determined. Enzyme-linked immunosorbent assay (ELISA) and western blotting were used to detect inflammatory markers. Oil Red O staining determined the lipid accumulation. An NLRP3 inflammasome agonist served to investigate the effects of FT on IR in 3T3-L1 adipocytes. Results:The high levels of blood insulin, glucose, and HOMA-IR induced by high-fat diet and STZ were significantly decreased by FT. The FT also reduced the level of C-reactive protein (CRP), interleukin (IL)-1β, IL-18, caspase-1, and increased the expression of glucose transporter 1 (GLUT1), insulin receptor substrate 1 (IRS1), and IRS2 in both the rat models and 3T3-L1 adipocytes. In addition, FT significantly relieved lipid accumulation in the liver of rats. Application of NLRP3 inflammasome agonist weakened the effect of FT on IR in the IR 3T3-L1 adipocytes.Conclusions: These results suggest that FT can ameliorate the high-fat diet-and STZ-induced IR in rats through inhibition of NLRP3 inflammasome.

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“…The same group evaluated the hypoglycemic risk determined the associated factors in a prospective case-crossover study including 25 women and 5 men with AI on treatment with a median age of 38.5 years. [41] Full biochemical profiles were documented, and a 24 h CGM system (CGMS) was performed for each patient during a Ramadan fasting day then again during a nonfasting day. IG levels during the 24 h period, the fasting period, and the fasting period after exclusion of the five postprandial hours were significantly lower during the fasting day than on the nonfasting day.…”

Section: Endocrine and Metabolic Disordersmentioning

confidence: 99%

The year in ramadan fasting research (2017): A narrative review

Beshyah

Hajjaji

Ibrahim

et al. 2018

Ibnosina Journal of Medicine and Biomedical Sciences

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Ramadan fasting is one of the five Pillars of Islam. While there are several exemptions from fasting, many Muslims with medical conditions still choose to fast. This may adversely affect their health if not addressed properly. Recently, there has been an increased interest in the health implications of Ramadan fasting. The authors performed a narrative, nonsystematic review of the literature including case reports, case series, and review articles indexed in PubMed and Google Scholar in a full calendar year. All records were reviewed by two coauthors at least. Studies were reviewed, summarized, and represented to provide a readily comprehensible concise account of the contributions made to research and clinical practice in 1 year (January–December 2017). The publications spanned physiological and clinical aspects and crossed conventional disciplinary lines in various languages, locations, and systems of journal access. A total of 92 and 82 were found in the PubMed and Google Scholar databases, respectively. Diabetes, hypoglycemia, insulin, and body composition were among the most relevant issues addressed this year. Discipline wise, diabetes, physiology, gastrointestinal, cardiovascular, eyes, respiratory, nephrology, neuropsychiatry, and endocrinology were most prominent. Other articles have considered professional competence, education, ethics, culture, and organization of care. Many of the research groups are based in emerging countries with Muslim-majority, but the publications are still widely distributed in internationally recognized journals. Several workers seem to have Ramadan fast at the center of their academic interest inferred from the number of publications to which they have contributed. The authors hope this review will help direct further research and should inform clinical practice guidance.

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The risk for hypoglycemia during Ramadan fasting in patients with adrenal insufficiency

Cited by 13 publications

References 20 publications

Analysis of Emergency Department Admissions with Hypo or Hyperglycemia in the Month of Ramadan

Analysis of Emergency Department Admissions with Hypo or Hyperglycemia in the Month of Ramadan

Intermittent fasting therapy promotes insulin sensitivity by inhibiting NLRP3 inflammasome in rat model

The year in ramadan fasting research (2017): A narrative review

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