Department of Paediatrics, BIRDEM2, Diabetic Association of Bangladesh.
Department of Paediatrics, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders 2, Dhaka 1000, Bangladesh.
Diabetes Res Clin Pract. 2021 Mar;173:108673. doi: 10.1016/j.diabres.2021.108673. Epub 2021 Feb 1.
Our aim was to investigate the ability, frequency of acute complications and impact on glycemic control in uncontrolled T1DM who fasted during Ramadan.
74 Patients with T1D who insisted on fasting were enrolled 1 month prior to Ramadan and given intensive education by Diabetes team on insulin dose, glucose monitoring and dietary adjustments. Patients were divided into two groups ; group A- HbA1c < 9%(<75 mmol/mol) and group B- HbA1c ≥ 9% (≥75 mmol/mol) and different variables were compared.
Most of the patients fasted 58 (78.4%) for more than 15 days. There was no significant difference (p = 0.790), while comparing the breaking the fast in the two groups. Hypoglycaemia was common acute complications among them. There was no significant difference in the frequency of hypoglycaemia between two groups (P = 0.448). There was increased insulin requirement in both groups during Ramadan (p = 0.00001), with an increase in basal insulin in well controlled (from 24 to 34 units). There was significant reduction of Post Ramadan mean HbA1C in both groups [P = 0.0001)].
Children, adolescents and young adults with T1D with poor glycaemic control can fast safely during Ramadan with proper education and intensive monitoring.
本研究旨在探讨未经治疗的 1 型糖尿病（T1DM）患者在斋月期间禁食的能力、急性并发症的发生频率及其对血糖控制的影响。
在斋月前 1 个月，我们招募了 74 名坚持禁食的 T1D 患者，并由糖尿病团队对他们进行了胰岛素剂量、血糖监测和饮食调整方面的强化教育。患者被分为两组：A 组 - HbA1c<9%（<75mmol/mol）和 B 组 - HbA1c≥9%（≥75mmol/mol），并比较了两组间的不同变量。
大多数患者（78.4%）禁食超过 15 天。两组在打破斋戒方面没有显著差异（p=0.790）。低血糖是常见的急性并发症。两组间低血糖的发生频率无显著差异（P=0.448）。两组患者在斋月期间胰岛素需求量均增加（p=0.00001），血糖控制良好的患者（从 24 单位增加到 34 单位）基础胰岛素用量增加。两组患者斋月后平均 HbA1C 均显著降低（P=0.0001）。
对于血糖控制不佳的儿童、青少年和年轻成人 1 型糖尿病患者，在进行适当的教育和强化监测的情况下，可以安全地在斋月期间禁食。
