Ain Shams University, Cairo, Egypt.
Paediatric Endocrinology Department, Mafraq Hospital, Abu Dhabi, United Arab Emirates.
Diabetes Res Clin Pract. 2019 Apr;150:274-281. doi: 10.1016/j.diabres.2018.12.014. Epub 2019 Jan 8.
To ascertain the pattern of diabetes management during Ramadan fasting in childhood and adolescence among physicians in Arab countries.
An online electronic survey questionnaire was distributed to physicians registered in the Arab society for Paediatric Endocrinology and Diabetes (ASPED).
Of the 167 responders, 114 (86.0%) were paediatricians and the remaining 14.4% were adult physicians. 117 (79.6%) would allow patients to fast and 60.7% of them emphasized providing education before fasting. 69.1% of physicians thought that their patients complete >50% of fasting days. 46.9% recognized those with hypoglycemia unawareness among the very high-risk group for fasting. 62% reported that fasting should be broken if symptomatic hypoglycemia regardless of glucose level and 48.2% indicated that blood glucose above 300 mg/dl is another indication. 63.4% of respondents would decrease basal insulin by 25%, and 52.8% reported that using insulin pump during fasting reduced the frequency of hypoglycemia. 81.1% recommend several dietary adjustments and 56.4% used rapid-acting insulin analog according to carbohydrate counting.
There is a wide variation in the management of children and adolescents with diabetes during Ramadan in ASPED countries. A targeted educational program for physicians and establishing a guideline for this challenging area is needed.
确定阿拉伯国家医生在儿童和青少年开斋节斋戒期间管理糖尿病的模式。
向阿拉伯儿内分泌糖尿病学会（ASPED）注册的医生分发了在线电子调查问卷调查表。
在 167 名应答者中，114 名（86.0%）为儿科医生，其余 14.4%为成人医生。117 名（79.6%）允许患者斋戒，其中 60.7%的人强调在斋戒前提供教育。69.1%的医生认为他们的患者完成了>50%的斋戒天数。46.9%的医生在极高风险的禁食人群中认识到低血糖意识障碍患者。62%的医生报告说，如果出现症状性低血糖，无论血糖水平如何，都应中断禁食，而 48.2%的医生表示血糖超过 300mg/dl 也是另一个指征。63.4%的受访者会将基础胰岛素减少 25%，52.8%的人报告说在禁食期间使用胰岛素泵可降低低血糖的频率。81.1%的人建议进行多次饮食调整，56.4%的人根据碳水化合物计数使用速效胰岛素类似物。
ASPED 国家在儿童和青少年糖尿病患者开斋节管理方面存在很大差异。需要针对医生开展有针对性的教育计划，并为这一具有挑战性的领域制定指南。
