Endocrine Department, Dubai Hospital, Dubai Health Authority, Alkhaleej Road, P.O. Box 7272, Dubai, United Arab Emirates.
Endocrine Department, Dubai Hospital, Dubai Health Authority, Alkhaleej Road, P.O. Box 7272, Dubai, United Arab Emirates.
Diabetes Res Clin Pract. 2021 Mar;173:108669. doi: 10.1016/j.diabres.2021.108669. Epub 2021 Jan 15.
There is limited evidence that evaluates the impact of fasting during Ramadan in pregnant women. We explored the safety of fasting in Gestational Diabetes Mellitus (GDM) in Ramadan, while understating the glycemic variability.
25 patients with GDM who choose to fast, were enrolled and provided optimum care that included Ramadan focused education and FreeStyle LibreFlashContinuous Glucose Monitoring(FSL-CGM) was utilized for 2-4 weeks assessment period of non-Ramadan days plus 2-3 weeks during Ramadan and medication adjustment.
The average glucose improved significantly, while time in target and percent above target numerically improved during Ramadan compared to pre-Ramadan. There was significant increment on the number of hypoglycemic events in Ramadan. The average lowest blood glucose reading reduced significantly by 14 mg/dL with average duration of hypoglycemic events increased significantly by 38.5 min.
Our study reinforces the importance of structured education before Ramadan to deliver optimal care for the management of diabetes. Strikingly FSL-CGM demonstrated that hypoglycemia is significantly increased during Ramadan Fasting. There was effective reflection of hyperglycemic spikes, immediately post Iftar. The results corroborated with the earlier studies for higher frequency of hypoglycemia during Ramadan fasting, under similar standards of care in high-risk patients with diabetes.
目前评估孕妇在斋月期间禁食影响的证据有限。我们探讨了在斋月期间患有妊娠期糖尿病（GDM）时禁食的安全性，同时了解血糖变异性。
我们招募了 25 名选择禁食的 GDM 患者，并为他们提供了最佳的护理，包括针对斋月的教育，以及使用 FreeStyle LibreFlash 连续血糖监测仪（FSL-CGM）进行 2-4 周的非斋月天数评估期，以及在斋月期间进行 2-3 周的评估，并进行药物调整。
与斋月前相比，平均血糖显著改善，而目标时间和目标以上时间的数值在斋月期间有所改善。斋月期间低血糖事件的数量显著增加。斋月期间平均最低血糖读数显著降低 14mg/dL，低血糖事件的平均持续时间显著增加 38.5 分钟。
我们的研究强调了在斋月前进行结构化教育的重要性，以提供最佳的糖尿病管理护理。令人惊讶的是，FSL-CGM 表明在斋月禁食期间低血糖显著增加。开斋后立即出现明显的高血糖峰值反射。结果与早期研究一致，即在高风险糖尿病患者中，在类似的护理标准下，禁食期间低血糖的频率更高。
