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2型糖尿病患者斋月禁食期间的血糖参数变化:一项前瞻性比较现实世界研究。

Glucometric parameter changes in patients with type 2 diabetes during ramadan fasting: A prospective comparative real-world study.

作者信息

Al Hayek Ayman, Al Zahrani Wael M, Al Dawish Mohamed Abdulaziz

机构信息

Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

出版信息

Metabol Open. 2024 Jul 26;23:100304. doi: 10.1016/j.metop.2024.100304. eCollection 2024 Sep.

Abstract

BACKGROUND

This study assessed glucometric changes in Type 2 diabetes mellitus (T2DM) patients before, during, and after Ramadan fasting using an intermittently scanned continuous glucose monitoring system (isCGMS).

METHODS

This prospective comparative study included T2DM patients aged 30-70 years who were receiving nonintensive insulin in Riyadh, Saudi Arabia. In addition to the baseline characteristics, glycated hemoglobin (HbA1c) and ambulatory glucose profile (AGP)-derived metric data were collected at three specific points: pre-, during-, and post-Ramadan. Self-care activities during Ramadan were evaluated using the Diabetes Self-Management Questionnaire (DSMQ).

RESULTS

Overall, a total of 93 T2DM patients were enrolled in the study. Their mean age ±SD age was 47.9 ± 7.5 years, and 51.6 % of them were males. Compared with pre- and post-Ramadan, there was a significant decrease in HbA1c (p < 0.001 for both periods), average glucose level (p = 0.001 and p = 0.026, respectively), glucose variability (p = 0.043 and p = 0.005, respectively), and % time above the range of 181-250 mg/dL (p < 0.001 for both periods), as well as a significant increase in % time in target (70-180 mg/dL) during Ramadan (p < 0.001 for both periods). However, the % time below 54 mg/dL was slightly greater during Ramadan than both pre- and post-Ramadan (p < 0.001 and p = 0.002, respectively). Furthermore, 32.3 % reported inadequate self-care behaviors during Ramadan.

CONCLUSIONS

Ramadan fasting could improve glucose levels in T2DM patients who were not on intensive insulin, with a relatively low incidence of hypoglycemia.

摘要

背景

本研究使用间断扫描式动态血糖监测系统(isCGMS)评估了2型糖尿病(T2DM)患者在斋月禁食前、禁食期间和禁食后的血糖变化情况。

方法

这项前瞻性对照研究纳入了沙特阿拉伯利雅得年龄在30 - 70岁、接受非强化胰岛素治疗的T2DM患者。除了基线特征外,在三个特定时间点收集糖化血红蛋白(HbA1c)和基于动态血糖图谱(AGP)得出的指标数据:斋月前、斋月期间和斋月后。使用糖尿病自我管理问卷(DSMQ)评估斋月期间的自我护理活动。

结果

总体而言,共有93名T2DM患者参与了本研究。他们的平均年龄±标准差为47.9 ± 7.5岁,其中51.6%为男性。与斋月前和斋月后相比,HbA1c(两个时期均p < 0.001)、平均血糖水平(分别为p = 0.001和p = 0.026)、血糖变异性(分别为p = 0.043和p = 0.005)以及血糖高于181 - 250 mg/dL范围的时间百分比(两个时期均p < 0.001)均显著降低,同时斋月期间血糖处于目标范围(70 - 180 mg/dL)的时间百分比显著增加(两个时期均p < 0.001)。然而,血糖低于54 mg/dL的时间百分比在斋月期间略高于斋月前和斋月后(分别为p < 0.001和p = 0.002)。此外,32.3%的患者报告在斋月期间自我护理行为不足。

结论

斋月禁食可改善未接受强化胰岛素治疗的T2DM患者的血糖水平,且低血糖发生率相对较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5832/11340621/50ec45c65f15/gr1.jpg

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