Jeffrey Kelson Diabetes Centre, Central Middlesex Hospital, London, UK.
Diabet Med. 2010 Mar;27(3):327-31. doi: 10.1111/j.1464-5491.2010.02948.x.
During Ramadan, Muslims fast from dawn to dusk for one lunar month. The majority of Muslim diabetic patients are unaware of complications such as hypoglycaemia during fasting. The safety of fasting has not been assessed in the UK Muslim population with diabetes. The aim of this study was to determine the impact of Ramadan-focused education on weight and hypoglycaemic episodes during Ramadan in a Type 2 diabetic Muslim population taking oral glucose-lowering agents.
We retrospectively analysed two groups. Group A attended a structured education programme about physical activity, meal planning, glucose monitoring, hypoglycaemia, dosage and timing of medications. Group B did not. Hypoglycaemia was defined as home blood glucose < 3.5 mmol/l.
There was a mean weight loss of 0.7 kg after Ramadan in group A, compared with a 0.6-kg mean weight gain in group B (P < 0.001). The weight changes observed were independent of the class of glucose-lowering agents used. There was a significant decrease in the total number of hypoglycaemic events in group A, from nine to five, compared with an increase in group B from nine to 36 (P < 0.001). The majority were in patients treated with short-acting sulphonylureas (group A-100%, group B-94%). At 12 months after attending the programme, glycated haemoglobin (HbA(1c)) reduction were sustained in group A.
Ramadan-focused education in diabetes can empower patients to change their lifestyle during Ramadan. It minimizes the risk of hypoglycaemic events and prevents weight gain during this festive period for Muslims, which potentially benefits metabolic control.
在斋月期间,穆斯林会进行为期一个月的白天禁食。大多数穆斯林糖尿病患者并不知道禁食期间会出现低血糖等并发症。在英国的穆斯林糖尿病人群中,尚未对禁食的安全性进行评估。本研究的目的是评估针对 2 型糖尿病穆斯林患者的以斋月为重点的教育方案对其在斋月期间的体重和低血糖事件的影响,这些患者正在服用口服降糖药物。
我们回顾性分析了两组患者。A 组参加了关于体力活动、膳食计划、血糖监测、低血糖、药物剂量和时间的结构化教育计划。B 组未参加。低血糖定义为家庭血糖<3.5mmol/L。
A 组在斋月后平均体重减轻了 0.7kg,而 B 组平均体重增加了 0.6-kg(P<0.001)。观察到的体重变化与所使用的降糖药物类别无关。A 组低血糖事件的总次数从 9 次显著减少到 5 次,而 B 组从 9 次增加到 36 次(P<0.001)。大多数低血糖事件发生在使用短效磺脲类药物的患者中(A 组为 100%,B 组为 94%)。在参加该项目 12 个月后,A 组的糖化血红蛋白(HbA1c)水平持续降低。
针对糖尿病的斋月重点教育可以使患者在斋月期间改变生活方式。它最大限度地降低了低血糖事件的风险,并防止了穆斯林在这个节日期间体重增加,这可能有助于代谢控制。