Javed Ahmed Phulpoto.
Glycemic control among pregnant diabetic women on insulin who fasted during the month of ramadan.
Rawal Med J Jan ;38(3):239-43.

Background: Ramadan fasting for pregnant women with diabetes mellitus remains controversial and under reported. The objective of this study was to determine the glycemic control in pregnant diabetic women on insulin who fasted during Ramadan. Study Design: Prospective Observational Study Duration of Study: Ramadan 1431 & 1432 AH, June 2010 to November 2011 Place of Study: Diabetic Clinic, Ghulam Mohammad Mahar Medical College, Sukkur. Methods: This was a prospective observational study carried out from June 2010 to November 2011 including pregnant diabetic women, who were on short-acting insulin, intermediate-acting insulin, or a combination of them, and opted to carry out Ramadan fasting. Glycemic control was assessed before, middle and after Ramadan fasting. Results: One hundred & eleven women opted to fast with 72 (64.9%) of them had type 2 diabetes mellitus and 83.8% of them required combined insulin (short-acting, intermediate-acting) therapy. The age of the participants was 32.13 ± 4.68 years, and the age of their pregnancies was 25.60 ± 7.12 weeks when the study was performed. The median number of days fasted was 25 days, and most of the women were able to fast for more than 15 days. There was no difference between glycemic control of type 2 diabetes mellitus and gestational diabetes mellitus women prior to fasting. However, only serum HbA1c reduced in gestational diabetes mellitus after Ramadan. Conclusion: The findings indicate that pregnant diabetic women on insulin were able to fast during Ramadan and that their glycemic control was improved during fasting period. They may also suggest that instead of absolute ban on fasting for pregnant diabetic women more practical approach and close consultation with health care providers might be more helpful. (Rawal Med J 2013;38: 239-243).

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