Achieving safer Ramadan fasting by keeping flexible glycemic targets during the day and tighter targets during the night in insulin treated people with type 2 diabetes.

AIM

To observe the effect of keeping flexible glycemic targets during fasting and tighter targets during non-fasting hours in insulin-treated people with type 2 diabetes during Ramadan.

METHODS

This prospective study was conducted at Baqai Institute of Diabetology and Endocrinology in 2014. People with T2DM on split mixed insulin therapy were recruited. The pre-Ramadan education given and insulin doses were adjusted before Ramadan. 24-hour telephonic helpline service was provided to achieve pre-determined glycemic targets and minimize complications.

RESULTS

A total of 54 people with T2DM with a mean age of 54.65 ± 9.32 years were recruited. Mean glucose levels achieved were 183.50 ± 30.91 mg/dl and 179.20 ± 36.27 mg/dl during the day and night respectively. Mean HbA1c (p-value < 0.0001) and serum creatinine (p-value 0.0010) significantly improved at the end of Ramadan. 0.6% episodes of hypoglycemia including one major hypoglycemia while 30% of episodes of hyperglycemia were recorded. No hospitalization needed.

CONCLUSION

By keeping flexible glycemic targets during the day and tighter targets during the night, safe fasting was feasible with significant improvement in overall glycemic control without significant major complications.