Altemimi Mahmood Thamer, Odhaib Samih A, Imran Husam J, Alhamza Ali, Almomin Ammar, Mansour Abbas A
Adult Endocrinology, Faiha Specialized Diabetes, Endocrine and Metabolism Center, University of Basrah, Basrah Health Directorate, Basrah, IRQ.
Cureus. 2020 Dec 8;12(12):e11976. doi: 10.7759/cureus.11976.
Background Premixed insulin and basal insulin plus short-acting insulin regimens may be of value for treating individuals with type 2 diabetes (T2DM) who are fasting during Ramadan due to simplicity and better compliance. The objective of this study was to compare the effectiveness of human premixed insulin to basal plus short-acting insulin regimens in the management of fasting individuals with T2DM during Ramadan. Methods We conducted a prospective observational study in Basrah (southern Iraq) on 30 individuals with T2DM who fast during Ramadan. The enrolled patients were assigned into two groups at random: one group received a human premixed insulin regimen, the other received a basal plus short-acting insulin regimen. A baseline clinical and biochemical analysis was gathered for all patients at recruitment two weeks before fasting and within four weeks after the end of fasting. Patients were assessed twice during fasting month for insulin dose adjustment and documentation for any hyperglycemia or hypoglycemia. Results Fourteen patients were assigned to the premixed group, and 16 patients were assigned to the basal plus short-acting insulin group. The mean patient age was 53 ± 8 years, and the mean T2DM duration was 9.3 ± 4.2 years. The two groups were matched by age, body mass index, and glycated hemoglobin (HbA1c). There was no significant difference between the initial and final mean HbA1c in both groups. However, there was more non-significant HbA1c reduction in the premixed group as compared to the basal plus short-acting insulin group. The number of hypoglycemic events and weight changes among the two groups was not significant. Conclusions Both human premixed and basal plus short-acting insulin regimens are equally useful for glycemic control for patients with T2DM who choose to fast in observance of the month-long holiday of Ramadan.
背景 预混胰岛素和基础胰岛素加短效胰岛素方案对于治疗斋月期间禁食的2型糖尿病（T2DM）患者可能具有价值，因为其简单易行且依从性更好。本研究的目的是比较人预混胰岛素与基础加短效胰岛素方案在管理斋月期间禁食的T2DM患者中的有效性。方法 我们在伊拉克南部的巴士拉对30名斋月期间禁食的T2DM患者进行了一项前瞻性观察研究。入选患者被随机分为两组：一组接受人预混胰岛素方案，另一组接受基础加短效胰岛素方案。在禁食前两周招募时以及禁食结束后四周内，为所有患者收集基线临床和生化分析数据。在禁食月期间对患者进行两次评估，以调整胰岛素剂量并记录任何高血糖或低血糖情况。结果 14名患者被分配到预混组，16名患者被分配到基础加短效胰岛素组。患者的平均年龄为53±8岁，T2DM的平均病程为9.3±4.2年。两组在年龄、体重指数和糖化血红蛋白（HbA1c）方面相匹配。两组的初始和最终平均HbA1c之间没有显著差异。然而，与基础加短效胰岛素组相比，预混组的HbA1c降低幅度更不显著。两组之间的低血糖事件数量和体重变化没有显著差异。结论 对于选择在斋月这个为期一个月的节日期间禁食的T2DM患者，人预混胰岛素和基础加短效胰岛素方案在血糖控制方面同样有效。
