Ismail Nor Azlin Mohamed, Olaide Raji Hadijat, Abd Wahab Norashikin, Mustafa Norlaila, Kamaruddin Nor Azmi, Abdul Jamil Muhammad
Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Iran J Med Sci. 2011 Dec;36(4):254-9.
Ramadan fasting for pregnant women with diabetes remains controversial and underreported. The objective of this study was to determine the glycemic control in pregnant diabetic women on insulin who fasted during Ramadan.
This was a retrospective study carried out over a period of three years including pregnant diabetic women, who were on short-acting, intermediate-acting, or a combination of them, and opted to carry out Ramadan fasting. Glycemic control was assessed before, middle and after Ramadan fasting.
Thirty seven women opted to fast with 24 (64.9%) of them had type 2 diabetes mellitus and 83.8% of them required combined insulin (short- acting, intermediate-acting) therapy. The age of the participants was 32.13±4.68 years, and the age of their pregnancies was 25.60±7.12 weeks when the study was performed. The median number of days fasted was 25 days, and most of the women were able to fast for more than 15 days. There was no difference between glycemic control of type 2 diabetes mellitus and gestational diabetes mellitus women prior to fasting. In the middle of Ramadan, serum fructosamine decreased in both groups. However, only serum HbA1c reduced in gestational diabetes mellitus after Ramadan.
the findings indicate that pregnant diabetic women on insulin were able to fast during Ramadan and that their glycemic control was improved during fasting period. They may also suggest that instead of absolute ban on fasting for pregnant diabetic women more practical approach and close consultation with health care providers might be more helpful.
糖尿病孕妇的斋月禁食仍存在争议且报道不足。本研究的目的是确定在斋月期间禁食的糖尿病孕妇使用胰岛素时的血糖控制情况。
这是一项为期三年的回顾性研究，纳入了使用短效、中效或两者联合胰岛素治疗且选择在斋月期间禁食的糖尿病孕妇。在斋月禁食前、期间和之后评估血糖控制情况。
37名女性选择禁食，其中24名（64.9%）患有2型糖尿病，83.8%的患者需要联合胰岛素（短效、中效）治疗。研究进行时，参与者的年龄为32.13±4.68岁，怀孕年龄为25.60±7.12周。禁食天数的中位数为25天，大多数女性能够禁食超过15天。禁食前，2型糖尿病女性和妊娠期糖尿病女性的血糖控制情况无差异。在斋月期间，两组的血清果糖胺均下降。然而，斋月后仅妊娠期糖尿病患者的糖化血红蛋白降低。
研究结果表明，使用胰岛素的糖尿病孕妇在斋月期间能够禁食，且禁食期间血糖控制得到改善。这也可能表明，对于糖尿病孕妇，与其绝对禁止禁食，更实际的方法以及与医疗保健提供者密切咨询可能更有帮助。
