Siddiqui N I, Kamrul-Hasan M, Hossain M A, Chanda P K, Bakar M A, Rahman M, Kader M A
Professor Md Nazrul Islam Siddiqui, Professor & Head, Department of Endocrinology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh. Email:
Mymensingh Med J. 2017 Apr;26(2):256-265.
Ramadan fasting is one of the five pillars of Islam and is obligatory for all healthy adult and adolescent Muslims. A significant number of patients with diabetes observe fasting during Ramadan. The objectives of this Ramadan Perspective Epidemiology and Education in Diabetes (RAPEED) study were to find out the current knowledge, attitude, and practices about Ramadan fasting among people with diabetes in Bangladesh. This retrospective cross-sectional study recruited 648 subjects with diabetes mellitus attending the Endocrinology outpatient department of a tertiary level hospital of Bangladesh within two months of the end of Ramadan in 2016. Socio-demographic data, data related to diabetes treatment, complications and co-morbidities; changes in lifestyle and diabetes treatment during Ramadan and frequency of hypoglycemia were collected from all. The mean age of the study population was 50.32±12.1 years and the majority (98.6%) had type 2 diabetes and 63.9% were overweight or obese. The majority (89.35%) of the patients fasted in Ramadan and among them, more than half of the fasters received physicians' advice for Ramadan fasting (60.6%) and changed diabetes medication (69.90%) during Ramadan. Although the amount of total food consumption was unchanged in more than one half (60.6%) of the fasters, majority of them reduced sugar-sweet intake (75.5%), increased fluid drinking (75.8%) and decreased physical activity (75.8%) during the month. A large portion (37.48%) of them did not check blood glucose and more than half (54.06%) of fasters failed to visit their physicians during Ramadan. Among them 14.85% experienced mild to moderate episodes of hypoglycemia and none had severe hypoglycemia and the most (61.6%) episodes of hypoglycemia occurred in the late evening. Hypoglycemic episodes were more frequent among insulin users, patients who had received fasting advice from physicians and in those who had adjusted diabetes drugs before Ramadan fasting. Safe Ramadan fasting is a great challenge not only for the patients but also the consulting physicians. Current study reflects the necessity of both physicians' expertise and patients' awareness for safe fasting.
斋月禁食是伊斯兰教的五大支柱之一，所有健康的成年和青少年穆斯林都必须遵守。相当多的糖尿病患者在斋月期间禁食。这项斋月糖尿病视角下的流行病学与教育（RAPEED）研究的目的是了解孟加拉国糖尿病患者对斋月禁食的现有知识、态度和做法。这项回顾性横断面研究在2016年斋月结束后的两个月内，招募了648名在孟加拉国一家三级医院内分泌科门诊就诊的糖尿病患者。收集了所有患者的社会人口统计学数据、与糖尿病治疗、并发症和合并症相关的数据；斋月期间生活方式和糖尿病治疗的变化以及低血糖发生频率。研究人群的平均年龄为50.32±12.1岁，大多数（98.6%）患有2型糖尿病，63.9%超重或肥胖。大多数（89.35%）患者在斋月期间禁食，其中一半以上的禁食者在斋月期间接受了医生关于斋月禁食的建议（60.6%）并更改了糖尿病药物（69.90%）。虽然超过一半（60.6%）的禁食者总食物摄入量没有变化，但他们中的大多数人在该月减少了含糖食物的摄入（75.5%），增加了液体摄入（75.8%）并减少了身体活动（75.8%）。其中很大一部分（37.48%）没有检测血糖，超过一半（54.06%）的禁食者在斋月期间没有去看医生。其中14.85%经历了轻度至中度低血糖发作，没有人发生严重低血糖，大多数（61.6%）低血糖发作发生在深夜。胰岛素使用者、接受过医生禁食建议的患者以及在斋月禁食前调整过糖尿病药物的患者中，低血糖发作更为频繁。安全的斋月禁食不仅对患者，而且对咨询医生来说都是一项巨大的挑战。当前的研究反映了医生的专业知识和患者对安全禁食的意识的必要性。
