Abdessadek M, Khabbal Y, Magoul R, Marmouzi I, Ajdi F
Laboratory of Neuroendocrinology and Nutritional and Climatic Environment, Faculty of Sciences, Sidi Mohammed Ben Abdellah University, Fez, Morocco; Department of Pharmacology and Pharmacovigilance, University Hospital of Fez, Morocco.
Faculty of Medicine and Pharmacy, Ibno Zohr University, Agadir, Morocco.
Ann Pharm Fr. 2019 Sep;77(5):374-381. doi: 10.1016/j.pharma.2019.04.003. Epub 2019 Jun 26.
Fasting has no adverse effects on healthy Muslims during Ramadan. However, it can induce serious complications for patients with type 2 diabetes (T2D). We aimed to follow the variation of some biochemical and clinical parameters in T2D patients before and after Ramadan; and to determine the incidence of fasting on hypoglycaemia and lactic acidosis associated with antidiabetic agents such as metformin.
This work is a prospective study conducted during Ramadan on 150 patients, recruited 2 to 3 weeks prior to the start. These patients were sensitized about the Ramadan lifestyle and diet as well as the medications to take.
This study results indicated a significant decrease of glycated haemoglobin (from 8.06% to 7.42%) and a similar trend in the fasting plasma glucose (from 1.81 to 1.36g/L) before and after Ramadan respectively. The serum lipid profile showed significant variations during the study period, and antidiabetic medications was associated with low serum lactate. The plasma creatinine and uric acid were reduced but remained insignificant.
Based on data from our study, we concluded that a safe fasting with a lower risk hypoglycaemia, can be achieved in a well-controlled patients, under antidiabetic drugs. However, the diabetes medication was associated with a small increase in serum lactate levels that seemed to be dose-independent and not affected by treatment duration.
斋月期间禁食对健康的穆斯林没有不良影响。然而,它可能会给2型糖尿病(T2D)患者带来严重并发症。我们旨在追踪斋月前后T2D患者某些生化和临床参数的变化;并确定禁食对抗糖尿病药物(如二甲双胍)相关低血糖和乳酸性酸中毒的发生率。
本研究是在斋月期间对150名患者进行的一项前瞻性研究,在开始前2至3周招募。这些患者了解了斋月期间的生活方式、饮食以及所服用的药物。
本研究结果表明,糖化血红蛋白显著下降(从8.06%降至7.42%),斋月前后空腹血糖也有类似趋势(分别从1.81降至1.36g/L)。研究期间血清脂质谱有显著变化,抗糖尿病药物与低血清乳酸有关。血浆肌酐和尿酸降低,但仍不显著。
根据我们的研究数据,我们得出结论,在抗糖尿病药物治疗下,病情控制良好的患者可以实现低血糖风险较低的安全禁食。然而,糖尿病药物与血清乳酸水平的小幅升高有关,这似乎与剂量无关,也不受治疗持续时间的影响。