Al-Agha Abdulmoein E, Kafi Shahd E, Zain Aldeen Abdullah M, Khadwardi Raghdah H
Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail.
Saudi Med J. 2017 Apr;38(4):366-371. doi: 10.15537/smj.2017.4.18750.
To assess the benefit of using the flash glucose monitoring system (FGMS) in children and adolescents with type 1 diabetes mellitus (T1DM) during Ramadan fasting. Methods: A prospective pilot study of 51 participants visited the pediatric diabetes clinic at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from between June until and July 2016. The FreeStyle® Libre™ FGMS (Abbott Diabetes Care, Alameda, CA, USA) was used. Hypoglycemia was defined as glucose values of less than 70 mg/dL, while hyperglycemia as glucose values of more than 150 mg/dL for all participants based on our institute's protocol. Results: Participants were able to fast for 67.0% of the total days eligible for fasting, whereas they did not fast on 33% of the days due to either hypoglycemia (15.4%) or non-diabetes-related reasons (17.6 %). None of the participants developed severe hypoglycemia. The mean number of hyperglycemic episodes during fasting hours was 1.29, per day, which was higher than that of hypoglycemic episodes (0.7). None of the participants developed diabetic ketoacidosis (DKA). Glycemic control with mean of estimated hemoglobin A1C reading during Ramadan (8.16 ± 1.64% [pre study]) to 8.2 ± 1.63% [post study] p=0.932. Conclusions: Children and adolescents with T1DM who use the FGMS could fast without the risk of life-threatening episodes of severe hypoglycemia (namely seizure, coma), or DKA during Ramadan. Adequate education and good glycemic control prior to Ramadan are important strategies in combination with the use of an FGMS to achieve better outcome.
评估在斋月禁食期间使用动态血糖监测系统（FGMS）对1型糖尿病（T1DM）儿童和青少年的益处。方法：一项前瞻性试点研究，共有51名参与者于2016年6月至7月期间前往沙特阿拉伯王国吉达阿卜杜勒阿齐兹国王大学医院的儿科糖尿病诊所就诊。使用了FreeStyle® Libre™ FGMS（美国加利福尼亚州阿拉米达的雅培糖尿病护理公司）。根据我们研究所的方案，所有参与者低血糖定义为血糖值低于70mg/dL，高血糖定义为血糖值高于150mg/dL。结果：参与者能够在符合禁食条件的总天数中禁食67.0%，而由于低血糖（15.4%）或非糖尿病相关原因（17.6%），他们在33%的天数中未禁食。没有参与者发生严重低血糖。禁食期间每小时高血糖发作的平均次数为每天1.29次，高于低血糖发作次数（0.7次）。没有参与者发生糖尿病酮症酸中毒（DKA）。斋月期间估计糖化血红蛋白读数的平均值从（研究前）8.16±1.64%降至（研究后）8.2±1.63%，p=0.932。结论：使用FGMS的T1DM儿童和青少年在斋月期间可以禁食，而不会有危及生命的严重低血糖发作（即癫痫、昏迷）或DKA的风险。在斋月前进行充分的教育和良好的血糖控制是与使用FGMS相结合以取得更好结果的重要策略。
