Predetermined Anti-Diabetic Drug Regimen Adjustments During Ramadan Fasting: An Observational Study of Safety

Abdallah M. Beano; Mohammad A. Zmaili; Zaid H. Gheith; Ahmad M. Naser; Munther S. Momani; Al-Motassem F. Yousef; Ayman Aref Zayed

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자료유형: 학술저널

저자정보: Abdallah M. Beano (The University of Jordan) Mohammad A. Zmaili (The University of Jordan) Zaid H. Gheith (The University of Jordan) Ahmad M. Naser (The University of Jordan) Munther S. Momani (The University of Jordan) Al-Motassem F. Yousef (The University of Jordan) Ayman Aref Zayed (The University of Jordan)

저널정보: 대한내분비학회 Endocrinology and Metabolism Endocrinology and Metabolism Vol.32 No.2

발행연도: 2017.1

수록면: 265 - 273 (9page)

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Background: Many Muslim type 2 diabetes mellitus (T2DM) patients choose to fast the month of Ramadan despite the possible adverse health effects brought about by the change in dietary habits, among other things. Clinical data regarding the safety of multi-drug regimens during fasting are particularly scarce. The aim of the study was to evaluate the safety of a drug protocol devised by the authors to accommodate Ramadan’s dietary changes, involving dose adjustments of four anti-diabetic drug regimens in T2DM patients fasting Ramadan. Methods: In this prospective, observational, open-label study, 301 T2DM patients who wished to fast Ramadan were followed during Ramadan and the preceding month. The incidence of hypoglycemia, diabetic ketoacidosis (DKA) and non-ketotic hyperosmolar state (NKHS) was monitored. Patients were classified into four groups: A group (those taking metformin, sulfonylurea and insulin [n=33]); B group (metformin and sulfonylurea [n=89]); C group (metformin and insulin [n=96]); and D group (premixed 70/30, glargine or regular insulin [n=82]). During Ramadan, drug doses were adjusted as percentages of their pre-Ramadan values: 75% for sulfonylureas, 75% for glargine, 75% for premixed insulin 70/30 in two doses, and 75% for regular insulin. Metformin was adjusted to a twice-daily regimen. Results: No cases of DKA or NKHS were reported. Hypoglycemia occurred at a lower rate than pre-Ramadan values in groups C, and D; and a similar rate in groups A, and B. Conclusion: The data suggested that using the above protocol to adjust the doses of anti-diabetic drugs is safe in T2DM patients in regards to hypoglycemia, DKA, and NKHS.

참고문헌 (31)

참고문헌 신청

Al-Arouj M / 2005 / Recommendations for management of diabetes during Ramadan / Diabetes Care 28:2305~2311

Salti I / 2004 / A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries: results of the epidemiology of diabetes and Ramadan 1422/2001 (EPIDIAR) study / Diabetes Care 27:2306~2311

Hassan A / 2014 / Diabetes during Ramadan: pre-approach model: presentation, risk stratification, education / Eur Rev Med Pharmacol Sci 18:1798~1805

Al-Arouj M / 2010 / Recommendations for management of diabetes during Ramadan: update 2010 / Diabetes Care 33:1895~1902

Karamat MA / 2010 / Review of diabetes management and guidelines during Ramadan / J R Soc Med 103:139~147

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