Tahapary Dicky L, Astrella Cindy, Kristanti Melly, Harbuwono Dante S, Soewondo Pradana
Division of Endocrinology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No.71, Central Jakarta, 10430, Indonesia; Metabolic, Cardiovascular and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jl. Salemba Raya No VI, Central Jakarta, DKI Jakarta, 10430, Indonesia.
Metabolic, Cardiovascular and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jl. Salemba Raya No VI, Central Jakarta, DKI Jakarta, 10430, Indonesia; Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No.71, Central Jakarta, 10430, Indonesia.
Diabetes Metab Syndr. 2020 Sep-Oct;14(5):1559-1570. doi: 10.1016/j.dsx.2020.07.033. Epub 2020 Aug 7.
Majority of Muslims with type 2 diabetes mellitus (T2DM) fasted during Ramadan regardless of possible risk of complication. This systematic review aims to assess the impact of Ramadan fasting on metabolic profile and hypoglycemia event among T2DM patients.
Literature searching was conducted on December 2019 at PUBMED, Medline (EBSCOhost), and ProQuest databases using the following keywords: Ramadan fasting, type 2 diabetes mellitus, glycemic and lipid profile, anthropometry measurements, and hypoglycemia. Observational studies in adults and published in English which analyze the glucose parameters, lipid profile, and hypoglycemia among T2DM patients during Ramadan were included in the analysis. All studies were assessed for its risk of bias using New-Castle Ottawa Scale. The heterogeneity of the studies was analyzed using I (square) test and the overall mean difference between studied parameters before and after Ramadan fasting was calculated using Weighted Mean Difference (WMD) test using Stata 13.
A total of 28 observational studies that were conducted in Middle Eastern, African, and Asian countries were included. This review found decrease in FPG level by -15.28 (95% CI -17.22, -13.34) mg/dl, HbA1c by -0.27 (95% CI -0.32, -0.22)%, total cholesterol by -12.88 (95% CI -14.68, -11.09) mg/dL, LDL-C by -4.42 (95% CI -6.17, -2.66)mg/dl, HDL-C by -1.09 (95% CI -1.71 - 0.47) mg/dL, triglyceride by -2.47 (95% CI -3.69 - 1.24) mg/dL and decreased anthropometry measurement. No studies reported fatal hypoglycemia event.
Ramadan fasting resulted in slight improvement of overall metabolic profile and anthropometry among T2DM patients with relatively low incidence of hypoglycemia.
大多数2型糖尿病（T2DM）穆斯林在斋月期间禁食，而不顾及可能出现的并发症风险。本系统评价旨在评估斋月禁食对T2DM患者代谢指标和低血糖事件的影响。
2019年12月在PubMed、Medline（EBSCOhost）和ProQuest数据库进行文献检索，使用以下关键词：斋月禁食、2型糖尿病、血糖和血脂谱、人体测量学指标、低血糖。纳入分析的是针对成年人且以英文发表的观察性研究，这些研究分析了斋月期间T2DM患者的血糖参数、血脂谱和低血糖情况。使用纽卡斯尔-渥太华量表对所有研究进行偏倚风险评估。采用I²检验分析研究的异质性，并使用Stata 13软件通过加权均数差（WMD）检验计算斋月禁食前后研究参数的总体均数差。
共纳入在中东、非洲和亚洲国家开展的28项观察性研究。本评价发现空腹血糖（FPG）水平降低了-15.28（95%CI -17.22，-13.34）mg/dl，糖化血红蛋白（HbA1c）降低了-0.27（95%CI -0.32，-0.22）%，总胆固醇降低了-12.88（95%CI -14.68，-11.09）mg/dL，低密度脂蛋白胆固醇（LDL-C）降低了-4.42（95%CI -6.17，-2.66）mg/dl，高密度脂蛋白胆固醇（HDL-C）降低了-1.09（95%CI -1.71，-0.47）mg/dL，甘油三酯降低了-2.47（95%CI -3.69，-1.24）mg/dL，且人体测量学指标下降。没有研究报告致命性低血糖事件。
斋月禁食使T2DM患者的总体代谢指标和人体测量学指标略有改善，低血糖发生率相对较低。
