M'guil M, Ragala M A, El Guessabi L, Fellat S, Chraibi A, Chabraoui L, Israili Z H, Lyoussi B
UFR Physiologie-Pharmacologie, Faculté des Sciences, Fès, Morocco.
Clin Exp Hypertens. 2008 Jul;30(5):339-57. doi: 10.1080/10641960802272442.
The study objective was to determine if Ramadan fasting was safe in patients with type 2 diabetes mellitus (T2D), based upon a determination of the effect of fasting on a broad range of physiological and clinical parameters, including markers of glycemic control and blood pressure. The study was carried out in Ramadan 1422 (December 2001-January 2002) at the Diabetology Services, Hopital Ibn Sina, Rabat, Morocco. One hundred and twenty T2D Moroccan patients (62 women, 58 men), aged 48-60 yrs with well-controlled diabetes through diet and/or oral hypoglycemic drugs (OHD), received dietary instructions and readjustment of the timing of the dose of OHD (gliclazide modified release) according to the fasting/eating periods. Anthropometric indices and physiological parameters (blood pressure, lipid, hematological, and serum electrolyte profiles, as well as markers of glycemic control, nutrition, renal and hepatic function) were measured on the day before Ramadan and then on the 15(th) and 29(th) day of fasting and thereafter 15 days later. Statistical analysis was done by standard methods. Ramadan fasting had no major effect on energy intake, body weight, body mass index, blood pressure, and liver enzymes. Fasting and post-prandial glucose levels decreased, while insulin levels increased. Diabetes was well controlled, as indicated by HbA1c, fructosamine, C-peptide, HOMA-IR, and IGF-1 values. There were fluctuations in some lipid and hematological parameters, creatinine, urea, uric acid, total protein, bilirubin, and electrolytes; however, all values stayed within the proper physiological range. In conclusion, diabetes was well-controlled in patients with dietary/medical management, without serious complications. With a regimen adjustment of OHD, diet control, and physical activity, most patients with T2D whose diabetes was well-controlled before Ramadan can safely observe Ramadan fasting.
该研究的目的是基于对禁食对一系列生理和临床参数（包括血糖控制指标和血压）的影响的测定，来确定斋月禁食对2型糖尿病（T2D）患者是否安全。该研究于伊历1422年斋月（2001年12月至2002年1月）在摩洛哥拉巴特的伊本·西那医院糖尿病服务中心进行。120名摩洛哥T2D患者（62名女性，58名男性），年龄在48 - 60岁，通过饮食和/或口服降糖药物（OHD）使糖尿病得到良好控制，他们接受了饮食指导，并根据禁食/进食时间重新调整了OHD（缓释格列齐特）的给药时间。在斋月前一天、禁食的第15天和第29天以及之后15天测量人体测量指标和生理参数（血压、血脂、血液学、血清电解质谱以及血糖控制、营养、肾和肝功能指标）。采用标准方法进行统计分析。斋月禁食对能量摄入、体重、体重指数、血压和肝酶没有重大影响。空腹和餐后血糖水平下降，而胰岛素水平升高。糖化血红蛋白、果糖胺、C肽、胰岛素抵抗指数（HOMA-IR）和胰岛素样生长因子-1（IGF-1）值表明糖尿病得到了良好控制。一些血脂和血液学参数、肌酐、尿素、尿酸、总蛋白、胆红素和电解质有波动；然而，所有值都保持在适当的生理范围内。总之，通过饮食/医学管理，糖尿病患者的病情得到了良好控制，没有严重并发症。通过调整OHD方案、饮食控制和体育活动，大多数在斋月前糖尿病得到良好控制的T2D患者可以安全地进行斋月禁食。
