The use of Free Style Libre Continues Glucose Monitoring (FSL-CGM) to monitor the impact of Ramadan fasting on glycemic changes and kidney function in high-risk patients with diabetes and chronic kidney disease stage 3 under optimal diabetes care

Alawadi, Fatheya; Rashid, Fouzia; Bashier, Alaaeldin; Abdelgadir, Elamin; Saeed, Muhammad; Abuelkheir, Sona; Khalifa, A.; Sayyah, Fatima; Bachet, Fawzi; Elsayed, Mohamed; Abdallah, Khadija; Hassanein, Mohamed

doi:10.1016/j.diabres.2019.03.015

Cited by 27 publications

(24 citation statements)

References 20 publications

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“…The incremental benefits are similar to those reported in the studies using structured NT delivered during the non-Ramadan period [7][8][9]. Although the reduction in HbA1c by 0.72% in sRNT group was not significantly different from the SC group (−0.35%), it was much higher than previously reported by Ramadan-focused education studies, where it ranged from 0.2%-0.4% among patients with T2D [10][11][12][13][14]. The improvement in HbA1c was unlikely due to medication or weight loss as both parameters remained unchanged throughout Ramadan.…”

Section: Discussionsupporting

confidence: 85%

“…This result indicates the feasibility of providing DSF as a part of the structured NT during Ramadan. Notably, the sRNT regimen was different from the other Ramadan-focused nutrition plans that did not include DSF in their intervention [11,12,14]. The incorporation of DSF in the sRNT was also different from other structured NT performed during the non-Ramadan period.…”

Section: Discussionmentioning

confidence: 93%

“…The optimal administration of structured NT regimen during Ramadan fasting remains unclear. Many studies have reported the benefits of providing Ramadan-focused intervention [4,[10][11][12][13][14]. Nonetheless, none of these studies have explored the potential of structured NT, including the use of DSF in patients' diets during Ramadan fasting.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Structured Nutrition Therapy for Ramadan with Standard Care in Type 2 Diabetes Patients

et al. 2020

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1) Background: Structured nutrition therapy (NT) is essential for the management of type 2 diabetes (T2D), but the optimal delivery during Ramadan fasting remains unclear. The present study aimed to evaluate the effect of structured NT program versus standard care in patients with T2D during Ramadan.(2) Methods: The present study was an 8-week, parallel, non-randomized study with patients' preference design involving 64 patients with T2D. The participants were asked to choose their preferred group, i.e., structured NT (Structured Ramadan NT, sRNT) or standard care (SC). The participants in the sRNT group received a Ramadan-focused nutrition plan, including a diabetes-specific formula throughout the study, whereas the patients in the SC group received standard nutrition care. Study outcomes included clinical outcomes and quality of life (QoL). Data was analyzed using two-way repeated-measures ANOVA and linear mixed-effects model. (3) Results: More than half of the participants (n = 38, 63%) chose sRNT as their preferred group. Both groups had comparable baseline characteristics. After 8-weeks of the respective intervention, participants in the sRNT group had lower levels of fasting plasma glucose (−0.9 ± 0.3 mmol/L vs. 0.2 ± 0.3 mmol/L, p < 0.05), triglycerides (−0.21 ± 0.08 mmol/L vs. 0.20 ± 0.17 mmol/L, p < 0.05), and self-monitoring glucose at pre-dawn (6.9 mmol/L vs. 7.8 mmol/L, p < 0.05) and pre-bedtime (7.6 mmol/L vs. 8.6 mmol/L, p < 0.05) than participants in the SC group. Although not different between groups, HbA1c levels decreased significantly in the sRNT (−0.72 ± 0.16%, p < 0.001) but not in the SC group (−0.35 ± 0.24%, p = 0.155). QoL and satisfaction scores improved significantly in sRNT group, but not in SC group.(4) Conclusions: The structured NT regimen for Ramadan is a feasible and beneficial program for T2D patients observing Ramadan fasting as it showed an improvement in clinical outcomes and QoL.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Comparison of Structured Nutrition Therapy for Ramadan with Standard Care in Type 2 Diabetes Patients

et al. 2020

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“…15 In a study, fasting rate of diabetes patients with chronic renal disease was found to be 63%, lasting for 25-30 days. 16 In this current study, more than half of the patients (56.1%) fasted and a majority of them (67.1%) fasted all month long. The reasons stated by those who reported they could not fast were associated with diseases.…”

Section: Discussionmentioning

confidence: 46%

“…Negative effects of fasting on the disease were observed in some of these studies 17 while the majority reported no negative effect. 1, 12,16,18,19 Moreover, there are also studies demonstrating the positive effect of fasting on some parameters, especially in eating and obesity-related diseases. 14,[20][21][22] It is known that the immune system has a role in the pathogenesis of rheumatic diseases.…”

Section: Discussionmentioning

confidence: 99%

Rheumatology patients' attitude regarding Ramadan and fasting

Pehlıvan

Yağız

et al. 2020

Int J of Rheum Dis

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Ramadan, the 9th month of the Islamic calendar, is a sacred month for Muslims. 1 Throughout Ramadan, Muslims should avoid all kinds of food, drinks, drugs, smoking and sexual intercourse between dawn and sunset. 1,2 Two main courses are eaten during Ramadan; 1 just before dawn (Suhur) and the other right after sunset (İftar). The time between the two courses may vary between 12 to 18 hours depending on seasonal and regional characteristics. 3 Studies conducted with healthy individuals suggest that Ramadan fasting is a non-pharmacological healthy way of protecting and improving health by minimizing disease-related risk factors (such as body weight, waist circumference, body mass index, body fat, blood glucose, systolic/diastolic blood pressure and anxiety level, pro-inflammatory cytokines interleukin [IL]-1b, IL-6, tumor necrosis factor and cancer). 4-6 However, Ramadan fasting also includes changes in

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Ramadan and Diabetes: A Narrative Review and Practice Update

et al. 2020

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Fasting in the Islamic month of Ramadan is obligatory for all sane, healthy adult Muslims. The length of the day varies significantly in temperate regions-typically lasting C 18 h during peak summer in the UK. The synodic nature of the Islamic calendar means that Ramadan migrates across all four seasons over an approximately 33-year cycle. Despite valid exemptions, there is an intense desire to fast during this month, even among those who are considered to be at high risk, including many individuals with diabetes mellitus. In this review we explore the current scientific and clinical evidence on fasting in patients with diabetes mellitus, focussing on type 2 diabetes mellitus and type 1 diabetes mellitus, with brief reviews on pregnancy, pancreatic diabetes, bariatric surgery, the elderly population and current practice guidelines. We also make recommendations on the management of diabetes patients during the month of Ramadan.

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The use of Free Style Libre Continues Glucose Monitoring (FSL-CGM) to monitor the impact of Ramadan fasting on glycemic changes and kidney function in high-risk patients with diabetes and chronic kidney disease stage 3 under optimal diabetes care

Cited by 27 publications

References 20 publications

Comparison of Structured Nutrition Therapy for Ramadan with Standard Care in Type 2 Diabetes Patients

Comparison of Structured Nutrition Therapy for Ramadan with Standard Care in Type 2 Diabetes Patients

Rheumatology patients' attitude regarding Ramadan and fasting

Ramadan and Diabetes: A Narrative Review and Practice Update

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