There is some evidence suggesting that use of a rapid-acting insulin analog instead of regular human insulin before meals in patients with type 2 diabetes who fast during Ramadan is associated with less hypoglycemia and smaller postprandial glucose excursions 38 Some patients with type 1 diabetes prefer to fast at Ramadan, and most of them change their insulin regimens immediately before, during, and a few days after this month.
In general, agents that act by increasing insulin sensitivity are associated with a significantly lower risk of hypoglycemia than compounds that act by increasing insulin secretion. Raising the general awareness of Ramadan and diabetes should strengthen the harmony between medical and religious advice.
Adapted from Akbani et al.
Fasting glucose concentrations are lower and postprandial glucose and insulin levels are substantially higher in healthy pregnant women than in healthy women who are not pregnant.
Background III Jewish religious fasts: If you decide to fast If, after consulting with your doctor, you decide to fast: On the other hand, an excessive reduction in the insulin dosage in these patients to prevent hypoglycemia may place them at risk for hyperglycemia and diabetic ketoacidosis.
We are happy to present information on Ramadan which, we hope, will prove to be useful source of Both require titration to effective doses over a period of 2—4 weeks and are associated with mild to moderate nausea in almost half of those exposed on at least one occasion, particularly as therapy is initiated.
Most will need to reduce their basal infusion rate while increasing the bolus doses to cover the predawn and sunset meals.
Such an advantage is not available to those treated with a conventional insulin injection in which insulin continues to be released from the site of injection throughout its predetermined duration of action.
J Appl Physiol ; One of them is that people who are ill or have medical conditions do not have to fast. Health care professionals should be trained to deliver a structured patient education program that includes a better understanding of fasting and diabetes, individual risk quantification, and options to achieve safer fasting.
More recently, apprehension has emerged regarding reports of increased frequency of macular edema and of bone fractures, particularly in postmenopausal women. Clinical studies with other types of insulin in multiple daily injection regimens during fasting are limited.
Patients treated with metformin alone may safely fast because the possibility of severe hypoglycemia is minimal. This assessment should also extend to those who do not wish to fast because they often are exposed to the risk of hypo- and hyperglycemia during Ramadan as a reflection of social habits encountered during the month.
Appropriate blood studies should be ordered and evaluated. In general, women with pregestational or gestational diabetes are at very high risk and may be strongly advised not to fast during Ramadan. The DCCT and its follow up, the Epidemiology for Diabetes Interventions and Complications EDIC study, demonstrated that intensive glycemia management is protective against microvascular and perhaps macrovascular complications and that the benefits are long lasting 19 With its short half-life of 2 h, it is not associated with a substantial effect on fasting glucose.
An effective strategy would be judicious use of intermediate- or long-acting insulin preparations plus a short-acting insulin administered before meals.
Additional studies on the use of sulfonylureas in patients who fast during Ramadan are needed before strong recommendations on their utility can be made. One study in patients with type 2 diabetes who fasted showed that use of repaglinide was associated with less hypoglycemia compared with glibenclamide Reduce burden of Type 2 diabetes by behavior change.
It is important to note that this occurred while glycemic control was maintained at the same level for 12 months 2. Appropriate counseling should be given to avoid this practice, and agents that were previously prescribed for the management of elevated cholesterol and triglycerides should be continued.
If you are taking insulin, you will require less insulin before the start of the fast The type of insulin may also need changing from your usual type Pre-mixed insulin is not recommended during fasting Before starting the fast, you should include more slowly absorbed food low GIsuch as basmati rice and dhal, in your meal, along with fruit and vegetables Check your blood glucose levels more often than you normally would When you break the fast, have only small quantities food, and avoid only eating sweet or fatty foods Try to eat just before sunrise, when you commence the next day's fast At the end of fasting you should drink plenty of sugar-free and decaffeinated fluids to avoid being dehydrated.
Diabetes Metab, Nancy C Midlin Company:Ramadan gives us the opportunity to fulfil our duty to Allah (SWT), cleanse our bodies and souls, and practice self-restraint. For some people with diabetes, fasting. Diabetes Mellitus and Fasting Ramadan may 2, views.
Share; Like; Download Mohammad Othman Daoud DM and Fasting CONCLUSIONS Education Diet control Daily activity Drug regimen adjustment Conclusion Until guidelines are available, the most important management strategy for health- care providers is Individualized Structured education Before and during Ramadan Ramadan.
Your diet should include plenty of fruits and vegetables, such as okra, aubergine and chickpeas. Frying food needs to be avoided, an alternative would be to grill or steam food.
Frying food needs to be avoided, an alternative would be to grill or steam food. Diabetes management in Ramadan - Dr.
Mohammed Sadiq Azam 2. The Holy Quran,Surah Al Baqarah – “Ramadan is the (month) in which was sent down the Quran, as a guide to mankind, also clear (Signs) for guidance and judgment (between right and wrong).
IDF has produced a series of guidelines on different aspects of diabetes management, prevention and care.
Diabetes and Ramadan: Practical Guidelines Ensuring the optimal care of the many people with diabetes who fast during Ramadan is crucial. Although recommendations for management of diabetes in patients who elect to fast during Ramadan were proposed in at a conference in Casablanca, our previous document was prompted by the EPIDIAR study.
The purpose of this review is to evaluate new data that has emerged since the publication of the article and to refine our elbfrollein.com by: