Deeb Asma, Al Qahtani Nabras, Akle Mariette, Singh Himanshi, Assadi Rifah, Attia Salima, Al Suwaidi Hana, Hussain Tara, Naglekerke Nico
Paediatric Endocrinology Department, Mafraq Hospital, AbuDhabi, United Arab Emirates.
Paediatric Endocrinology Department, Mafraq Hospital, AbuDhabi, United Arab Emirates.
Diabetes Res Clin Pract. 2017 Apr;126:10-15. doi: 10.1016/j.diabres.2017.01.015. Epub 2017 Feb 1.
Sick individuals and children are exempted from fasting Ramadan. Fasting by type 1 diabetes patients might predispose to acute complications. There are no guidelines on fasting safety or its impact on diabetes control in children and adolescents. We aim to assess patients' attitude towards fasting, frequency of complications and impact on glycemic control in children with type 1 diabetes.
RESEARCH DESIGN & METHODS: 65 children with type 1 diabetes were enrolled. The study involved 2 hospital visits. Questionnaires were filled in each visit and HbA1c was recorded. Log books indicating symptomatic hypoglycemia and hyperglycemia leading to breaking fast were obtained.
Majority of subjects were willing to fast and 75% were encouraged by parents to do. 57% and 26% fasted more than half and all through the month respectively. 52% had, at least, one episode of hypoglycemia and 29% had hyperglycemia with one episode of ketoacidosis. All patients broke fast in response to symptomatic hypoglycemia/hyperglycemia. There was no significant difference between the frequency of complications in the pump or the Multiple Daily Injection (MDI) groups. Mean HbA1c increased from 70mmol/mol to 73mmol/mol. The difference was not statistically significant.
Children and adolescents with type 1 diabetes are keen to fast Ramadan and they are able to fast a significant number of days. Hypoglycemia and hyperglycemia are not uncommon with no difference between Pump or in MDI users. Breaking fast on occurrence of complications makes fasting safe. Glycemic control might deteriorate during the month and the following Eid.
患病个体和儿童可免于斋月禁食。1型糖尿病患者禁食可能易引发急性并发症。目前尚无关于儿童和青少年禁食安全性及其对糖尿病控制影响的指南。我们旨在评估1型糖尿病儿童患者对禁食的态度、并发症发生频率以及对血糖控制的影响。
招募了65名1型糖尿病儿童。该研究包括两次医院就诊。每次就诊时填写问卷并记录糖化血红蛋白（HbA1c）。获取记录有导致破斋的症状性低血糖和高血糖情况的日志。
大多数受试者愿意禁食，75%的受试者受到父母鼓励进行禁食。分别有57%和26%的受试者禁食超过半个月和整个月。52%的受试者至少有一次低血糖发作，29%的受试者有高血糖发作且伴有一次酮症酸中毒发作。所有患者均因症状性低血糖/高血糖而破斋。胰岛素泵组和多次皮下注射（MDI）组的并发症发生频率无显著差异。平均糖化血红蛋白从70mmol/mol升至73mmol/mol。差异无统计学意义。
1型糖尿病儿童和青少年渴望在斋月禁食，并且能够禁食相当多的天数。低血糖和高血糖并不罕见，胰岛素泵使用者和MDI使用者之间无差异。出现并发症时破斋可确保禁食安全。在斋月期间及随后的开斋节期间，血糖控制可能会恶化。
