Metabolic parameters in type 2 diabetic patients with varying degrees of glycemic control during Ramadan: An observational study

• Published in: Journal of diabetes investigation Vol. 7; no. 1; pp. 70 - 75
• Main Authors: Siaw, Melanie Y. L., Chew, Daniel E. K., Toh, Matthias P. H. S., Seah, Darren E. J., Chua, Ruimin, Tan, Jielin, Lee, Evonne Y. Q., Chan, Sui Yung, Lee, Joyce Y. C.
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.01.2016; John Wiley and Sons Inc
• Subjects: Aged; Blood Glucose - metabolism; Blood pressure; Cardiovascular disease; Cholesterol; Chronic illnesses; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - ethnology; Fasting - blood; Female; Glomerular filtration rate; Glucose; Glycated Hemoglobin A - metabolism; Glycemic Index - physiology; Hemoglobin; Humans; Islam; Laboratories; Male; Metabolic parameters; Metabolism; Middle Aged; Muslims; Observational studies; Original; Patients; Ramadan; Retrospective Studies; Singapore - ethnology; Studies; Trends; Triglycerides; Type 2 diabetes; Singapore; Ramadan; Metabolic parameters; Type 2 diabetes
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.12374

Aims/Introduction The changes in metabolic parameters in type 2 diabetic patients who fast during Ramadan have not been studied in Singapore. This study aimed to examine the trends of glycated hemoglobin (HbA1c), systolic blood pressure, low‐density lipoprotein cholesterol, and triglycerides in diabetic patients with varying degrees of glycemic control and different types of therapeutic approaches during Ramadan. Methods The present retrospective study used a national electronic database to examine the metabolic parameter of Malay patients with type 2 diabetes. Eligible patients were stratified into three groups based on their mean HbA1c control before Ramadan: group 1 (HbA1c ≥10%), group 2 (HbA1c 7.1–9.9%) and group 3 (HbA1c ≤7%). Patients with a glomerular filtration rate <15 mL/min were excluded. The trends of metabolic parameters were traced before, during and after Ramadan. Results Of 13,565 patients examined, 5,172 patients (38.1%) were eligible for this study. Mean change of HbA1c varied from −1.4% to +0.2% during Ramadan, with the greatest reduction observed in group 1 (P < 0.001). A minimal systolic blood pressure reduction was observed in groups 2 and 3 (2 mmHg; P < 0.01). Low‐density lipoprotein cholesterol and triglycerides changes were insignificant. A small, 0.1%, reduction in mean HbA1c was observed in patients taking oral antidiabetic agents during Ramadan (P < 0.001). Conclusions Blood glucose was most affected during Ramadan, particularly in patients with mean baseline HbA1c ≥10%. The type of antidiabetic agent used did not seem to contribute to glycemic changes. This was a large study which examined changes in metabolic parameters in type 2 diabetic patients who practice Ramadan fasting in Singapore. It is also the first in the literature to illustrate that the varying degrees of change in these parameters during Ramadan appeared to be related to patients' glycemic control before Ramadan. In this study, the largest change observed during Ramadan was in HbA1c, whereas the other metabolic parameters did not appear to change significantly.