Department of Medicine, Malacca General Hospital, Malaysia.
School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Malaysia.
Diabetes Res Clin Pract. 2021 May;175:108854. doi: 10.1016/j.diabres.2021.108854. Epub 2021 May 5.
The objective of this study was to determine admissions for diabetes emergencies among patients who fasted or planned to fast one month before, during and one month after Ramadan 2019 in public hospitals in Malaysia.
This was a cross sectional prospective study done in 18 public hospitals in Malaysia from 7/4/2019 to 2/7/2019. Data was collected prospectively with universal sampling. All adult Muslim patients with previous diagnosis of diabetes, who were admitted for hypoglycemia, DKA or HHS were included if they had fasted and had intentions to fast.
295 admissions for diabetes emergencies were analyzed. The pre-Ramadan period recorded the highest number of admissions (119) followed by during (106) and post-Ramadan (70). Admissions for hyperglycemic emergencies accounted for 2/3 of total admissions. 37% of admissions for hypoglycemia occurred during pre-Ramadan period compared to 32.1% during Ramadan. Contributing factors included use of sulphonylurea (59.6%), presence of nephropathy (54.5%) and past history of hypoglycemia (45.5%). Admissions for DKA were more common than HHS (119 versus 77) and highest during Ramadan period (36.1%). Most of the admissions for hyperglycemic emergencies were among those with Type 2 diabetes (75.9% for DKA and 97.4% for HHS). Only 31.5% of patients admitted for diabetes emergencies recalled having received Ramadan advice in the past.
Admissions for diabetes emergencies were highest during pre-Ramadan period followed by Ramadan and post-Ramadan period. This suggests that fasting during Ramadan does not increase admissions for diabetes emergencies.
本研究旨在确定 2019 年斋月期间（前一个月、斋月期间和后一个月），马来西亚公立医院中禁食或计划禁食的糖尿病患者因糖尿病急症入院的情况。
这是一项在马来西亚 18 家公立医院进行的横断面前瞻性研究，时间为 2019 年 7 月 4 日至 2019 年 2 月 7 日。通过普遍抽样进行前瞻性数据收集。所有患有糖尿病且之前有过低血糖、DKA 或 HHS 住院史的成年穆斯林患者，如果他们有禁食或计划禁食的意愿，且因低血糖、DKA 或 HHS 住院，均被纳入研究。
共分析了 295 例糖尿病急症入院病例。前斋月期间的入院人数最多（119 例），其次是斋月期间（106 例）和后斋月期间（70 例）。高血糖急症的入院人数占总入院人数的 2/3。前斋月期间低血糖的入院率为 37%，而斋月期间低血糖的入院率为 32.1%。导致低血糖的因素包括使用磺脲类药物（59.6%）、合并肾病（54.5%）和既往低血糖病史（45.5%）。DKA 的入院人数多于 HHS（119 例比 77 例），且在斋月期间最多（36.1%）。大多数高血糖急症的入院患者为 2 型糖尿病患者（DKA 为 75.9%，HHS 为 97.4%）。只有 31.5%的糖尿病急症入院患者过去曾接受过斋月建议。
前斋月期间、斋月期间和后斋月期间的糖尿病急症入院人数最高。这表明，在斋月期间禁食不会增加糖尿病急症的入院人数。
