糖尿病患者的斋月日间间歇性禁食：知识、实践、并发症风险评估以及斋月前教育的影响
Ramadan diurnal intermittent fasting in patients with diabetes: assessment of knowledge, practices, risk of complications, and impact of pre-ramadan education.
作者信息
Oueslati Ibtissem, Cherif Lina, Aloui Emna, Mabrouk Meriem, Yazidi Meriem, Chihaoui Melika
机构信息
Department of Endocrinology, La Rabta Hospital, Rue Jbel Lakhdar, La Rabta Jebbari 1007, Tunis, Tunisia.
Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
出版信息
J Diabetes Metab Disord. 2024 Dec 16;24(1):9. doi: 10.1007/s40200-024-01529-w. eCollection 2025 Jun.
OBJECTIVES
Evaluate diabetic patients' knowledge, practices, and the prevalence of complications during Ramadan fasting (RF) before and after an education program.
METHODS
We conducted a prospective study including 140 consecutive diabetic patients (DP) who intended to observe RF in 2023. Patients underwent a questionnaire and received pre-Ramadan education (PRE) according to the IDF-DAR 2021 recommendations. Practices and outcomes (hypoglycemia, hyperglycemia, and cardiovascular events) of RF patients were determined during Ramadan 2022 and 2023 using a questionnaire.
RESULTS
Participants mean age was 56.0 ± 9.3 years. Their knowledge level was good, average, and poor in 37.1%, 35%, and 27.9% of cases, respectively. Before RF 2022, 40.9% of patients reported consulting their physicians about diabetes management during fasting and 12.1% received education. The risk stratification showed that 45.7% of patients were at low risk, 32.9% at moderate risk, and 21.4% at high risk. Compared to 2022 RF, significant changes in eating patterns and physical activity practice were observed in 2023. Self-monitoring blood glucose (SMBG) was practiced by 35.6% of patients in 2022 and 75% in 2023 ( < 0.001). The number of patients who fasted the whole month of Ramadan and hypoglycemia prevalence were comparable between 2022 and 2023. Hyperglycemia prevalence was higher in 2023 (14.9%) than in 2022 (3%) ( < 0.001). No severe hypoglycemia, cardiovascular events, or hospital admissions were observed during RF 2022 and 2023.
CONCLUSION
The majority of diabetic patients had poor to average knowledge about diabetes and fasting. They were categorized as moderate- to high-risk of complications during RF. PRE had a positive impact on lifestyle, dietary patterns, and SMBG practice. Although this education did not lead to a decrease in hypoglycemia or hyperglycemia events, no severe metabolic or cardiovascular complications were reported.
目的
评估在一项教育项目前后，糖尿病患者在斋月禁食（RF）期间的知识、实践情况及并发症患病率。
方法
我们开展了一项前瞻性研究，纳入了2023年打算进行斋月禁食的140例连续糖尿病患者（DP）。患者接受问卷调查，并根据国际糖尿病联盟糖尿病与斋月2021年建议接受斋月前教育（PRE）。使用问卷确定2022年和2023年斋月期间斋月禁食患者的实践情况及结果（低血糖、高血糖和心血管事件）。
结果
参与者的平均年龄为56.0±9.3岁。其知识水平良好、一般和较差的病例分别占37.1%、35%和27.9%。在2022年斋月禁食前，40.9%的患者报告在禁食期间就糖尿病管理咨询过医生，12.1%的患者接受过教育。风险分层显示，45.7%的患者为低风险，32.9%为中度风险，21.4%为高风险。与2022年斋月禁食相比，2023年观察到饮食模式和体育活动实践有显著变化。2022年35.6%的患者进行自我血糖监测（SMBG），2023年为75%（P<0.001）。2022年和2023年整个斋月禁食的患者数量及低血糖患病率相当。2023年高血糖患病率（14.9%）高于2022年（3%）（P<0.001）。在2022年和2023年斋月禁食期间未观察到严重低血糖、心血管事件或住院情况。
结论
大多数糖尿病患者对糖尿病和禁食的知识了解较差或一般。他们在斋月禁食期间被归类为并发症的中度至高度风险人群。斋月前教育对生活方式、饮食模式和自我血糖监测实践有积极影响。尽管这种教育并未导致低血糖或高血糖事件减少，但未报告严重的代谢或心血管并发症。
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