Department of Internal Medicine, College of Medicine, King Saud University, Saudi Arabia.
Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Diabetes Metab Syndr. 2022 Aug;16(8):102567. doi: 10.1016/j.dsx.2022.102567. Epub 2022 Jul 20.
People with type 1 diabetes (T1D) are advised to have a "pre-Ramadan" visit to receive the assessment and education needed to safely fast during the holy month of Ramadan. The COVID-19 lockdown has interrupted this standard of care in Muslim-majority countries where telemedicine is not well-established. Here, we examined the impact of virtual"pre-Ramadan" visits, as an alternative option to the traditional (in-person) visits, on fasting experience and glycemic control during Ramadan in people with T1D.
151 individuals with T1D were categorized into 3 groups according to the type of"pre-Ramadan" visit that they attended in 2020: virtual (n = 50), in-person (n = 56), and no visit (n = 45). Number of days fast was broken and CGM metrics were retrospectively compared across the groups.
Patients who had a virtual"pre-Ramadan" visit were more likely to use continuous glucose monitors (CGM) than those who had no visit (61.7% and 38.6%, respectively, p < 0.05). Attending a virtual"pre-Ramadan" visit was associated with the least number of days fast was broken compared to those who had no visit (p < 0.01) or in-person visit (p = 0.02). CGM time in range (TIR) during Ramadan was the highest in those who had virtual "Pre-Ramadan" visits compared to those who had no visit or in-person visits (59%, 44%, and 47%,respectively). After adjusting for age, gender, pre-Ramadan A1c, and CGM use, the odds of fasting most days of Ramadan were highest in the virtual group [OR (CI): 9.13 (1.43, 58.22)] followed by the in-person group [3.02 (0.54,16.68)] compared to the no visit group.
Virtual"pre-Ramadan" visits are effective alternative to in-person visits when managing people with T1D who plan to fast during Ramadan.
建议 1 型糖尿病（T1D）患者在斋月前进行一次“预斋月”访问，以接受必要的评估和教育，从而安全地在斋月期间禁食。在穆斯林占多数的国家，由于远程医疗尚未得到充分发展，COVID-19 封锁中断了这种标准的护理。在这里，我们研究了虚拟“预斋月”访问作为传统（面对面）访问的替代方案，对 T1D 患者在斋月期间禁食体验和血糖控制的影响。
根据 2020 年他们参加的“预斋月”访问类型，将 151 名 T1D 患者分为 3 组：虚拟（n=50）、面对面（n=56）和无访问（n=45）。回顾性比较各组的禁食天数和连续血糖监测（CGM）指标。
与无访问组相比，进行虚拟“预斋月”访问的患者更有可能使用连续血糖监测仪（CGM）（分别为 61.7%和 38.6%，p<0.05）。与无访问或面对面访问相比，进行虚拟“预斋月”访问与禁食天数最少有关（p<0.01）。与无访问或面对面访问相比，虚拟“预斋月”访问期间 CGM 时间在目标范围内（TIR）最高（分别为 59%、44%和 47%）。在校正年龄、性别、预斋月 A1c 和 CGM 使用后，虚拟组禁食斋月大部分天数的几率最高[比值比（CI）：9.13（1.43，58.22）]，其次是面对面组[3.02（0.54，16.68）]，与无访问组相比。
在管理计划在斋月禁食的 T1D 患者时，虚拟“预斋月”访问是面对面访问的有效替代方案。
