Muhammad Yaqoob Ahmadani, Mahwish Riaz, Asma Gul, Muhamad Imran Waheed, Zafar Iqbal Hydrie, Rubina Hakeem, Abdul Basit.
Clinical profile of fasting diabetic subjects during ramadan.
J Coll Physicians Surg Pak Jan ;17(7):446-7.

This study was carried out at Baqai Institute of Diabetology and Endocrinology (BIDE), its affiliated centers as well as from Memon Diabetic and Diagnostic Centre of Karachi. It was a retrospective study. The questionnaire included the information regarding socio-demographic status, duration of diabetes, lifestyle, diet and treatment during and preceding Ramadan. Subjects were recruited just after Eid-ul-Fiter from 16 th November 2004 to 15th January 2005 and included all known type 1 and type 2 diabetic Muslim subjects. Children under 10 years of age were excluded from the study. Symptoms of hypoglycemia and hyperglycemia were specifically asked and recorded. Out of the 453 subjects, 327 (72.5 %) fasted during the month of Ramadan. Average duration of diabetes of these subjects was 9.3± 7.3 years. Three hundred and fifteen (96.3%) subjects with type 2 diabetes and 12 (3.7%) subjects with type 1 diabetes fasted. Subjects fasted for an average of 25 days. In fasting diabetic subjects, the overall prevalence of hypoglycemia and hyperglycemia was 20% and 21% respectively. Only 4.0% had major hypoglycemic episodes, while 8% had major hyperglycemic episodes. Out of 71 subjects, who experienced hypoglycemia during fasting, 23 (32%) subjects checked plasma glucose level during hypoglycemia and the mean plasma glucose level noted was 73 mg/dl. During major hyperglycemia episodes, 33 (51%) out of 65 subjects, checked plasma glucose levels during hyperglycemic episodes and the mean plasma glucose level noted was 277 mg/dl. Change in medicine timing, diet and physical activity during Ramadan had no effect on the proportion of hypoglycemia and hyperglycemia during Ramadan. There was no significant increase in the caloric intake of diet during Ramadan with fasting (p-value =0.503) and without fasting (p-value =0.309) compared with the diet before Ramadan. The study also showed no difference in the prevalence of hypoglycemia and hyperglycemia between type 1 and type 2 diabetic subjects during Ramadan.

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