Shaltout Inass, Zakaria Abir, Abdelwahab Amr Mahmoud, Hamed AbdelKhalek, Elsaid Nehal Hamdy, Attia Mazen Ahmed
Internal Medicine Department, Faculty of Medicine, Cairo University, Kasr Al-Ainy Faculty of Medicine, Al-Manial Street, Cairo, 11956 Egypt.
Diabetes and Endocrinology Unit, Faculty of Medicine, Minia University, Ard Shalaby, Main Road, Minia, Egypt.
J Diabetes Metab Disord. 2020 Jan 30;19(1):179-186. doi: 10.1007/s40200-020-00489-1. eCollection 2020 Jun.
In the current study, we aimed at evaluating the effect of a culturally-based pre-Ramadan education program (PREP) on glycemic control, weight, adherence to post-sunset physical activity, perception of hypoglycemia, and anti-diabetic medication dose adjustment during Ramadan fasting in type 2 diabetics.
A total of 1008 type 2 Diabetes patients were offered a culturally-based PREP in addition to the standard of care, two months before Ramadan. A retrospective interview one month after Ramadan compared the fasting experience of PREP attendees (470 patients) with those who merely received standard of care (538 patients) (Non-PREP).
Ramadan fasting improved glycemic control with a correlation between HbA1c percent reduction and the number of fasting days (r = -0.290, = 0.007). More HbA1c and weight percent reduction were observed in PREP attendees compared to the Non-PREP group (-14.8% ± 9.3 vs. -5.4% ± 5.4; < 0.001; and - 1.96% ± 5.4 vs. -0.39% ± 2.8; p < 0.001, respectively). More commitment to night prayers in the PREP attendees compared to the Non-PREP group, (85.5% prayed >20 nights vs 28.4%; p < 0.001) with more HbA1c and weight percent reduction in the those who performed the prayers more than 20 nights compared to those who performed no prayers (-11.69% ± 8.8 vs -6.28% ± 6.4, p < 0.001; and - 2.76% ±5.1 vs 1.35% ±1.8, p < 0.001, respectively). More perception of true hypoglycemia was associated with PREP attendance (p0.046), insulin treatment (p0.000), and reduction of antidiabetic medication dosage (p0.004). Repeated lowering of antidiabetic medications doses with sequential downsizing of meals' portions, and appetite was reported.
Ramadan fasting was beneficial for people with type 2 diabetes with reduction of HbA1c in correlation with the number of fasting days. Contrasting PREP with Non-PREP participants discovered better HbA1c and weight reduction in the former group even with equal number of fasting days. PREP participants performed more Taraweeh night prayers. The more the prayer nights the more decline of HbA1c and weight was observed. PREP improved perception and response to hypoglycemia with low-dosing of antidiabetic medications, especially insulin.
在本研究中，我们旨在评估一项基于文化的斋月前教育计划（PREP）对2型糖尿病患者在斋月禁食期间血糖控制、体重、日落后体育活动依从性、低血糖感知以及抗糖尿病药物剂量调整的影响。
在斋月前两个月，除了标准治疗外，共1008名2型糖尿病患者接受了基于文化的PREP。斋月后一个月进行的回顾性访谈比较了PREP参与者（470例患者）与仅接受标准治疗的患者（538例患者）（非PREP）的禁食体验。
斋月禁食改善了血糖控制，糖化血红蛋白（HbA1c）降低百分比与禁食天数之间存在相关性（r = -0.290，P = 0.007）。与非PREP组相比，PREP参与者的HbA1c和体重降低百分比更高（-14.8% ± 9.3 vs. -5.4% ± 5.4；P < 0.001；以及-1.96% ± 5.4 vs. -0.39% ± 2.8；P < 0.001）。与非PREP组相比，PREP参与者对夜间祈祷的参与度更高（85.5%祈祷超过20晚 vs 28.4%；P < 0.001），与未祈祷的人相比，祈祷超过20晚的人HbA1c和体重降低百分比更高（-11.69% ± 8.8 vs -6.28% ± 6.4，P < 0.001；以及-2.76% ± 5.1 vs 1.35% ± 1.8，P < 0.001）。更多的真正低血糖感知与参与PREP（P = 0.046）、胰岛素治疗（P = 0.000）以及抗糖尿病药物剂量减少（P = 0.004）相关。报告了随着餐量依次减少而反复降低抗糖尿病药物剂量以及食欲情况。
斋月禁食对2型糖尿病患者有益，HbA1c降低与禁食天数相关。将PREP参与者与非PREP参与者对比发现，即使禁食天数相同，前一组的HbA1c和体重降低情况更好。PREP参与者进行更多的塔拉威夜祷。祈祷的夜晚越多，观察到的HbA1c和体重下降越多。PREP改善了对低血糖的感知和反应，并减少了抗糖尿病药物尤其是胰岛素的剂量。
