Background: Change in meal timing and content during Ramadan fasting predisposes patients with type 2 diabetes to adverse glycaemic changes like hypoglycemia. Ambulatory blood glucose monitoring (ABGM) may be a valuable tool for monitoring and prevention of complications.
Methods: A single center observational surveillance, conducted during Ramadan, May 2018. ABGM was recorded 7 days before Ramadan and during first 7 days of fasting using the FreeStyle® Libre™. All patients received Ramadan related education and appropriate adjustments to the dosage and timing of medication as per IDF-Ramadan guidelines. Average glucose level and glycaemic variability were compared before and during the fasting period.
Results: 59 patients gave consent to ABGM during Ramadan fasting. Their mean age was 51.4 years, duration of diabetes 6.5 years, BMI 28.2 kg/m2, systolic blood pressure 124.2 mm Hg and diastolic blood pressure 79.6 mm Hg. Antidiabetic medication included metformin (100%), sulfonylureas (72.9%), dipeptidyl peptidase inhibitors (83%) and alpha-glucosidase inhibitor (6.8%). Co-morbidities included hypertension (52%), dyslipidemia (44%), neuropathy (33.9%) and hypothyroidism (12%). Mean HbA1c was 7.7%. Average glucose levels noted 7 days before Ramadan was 143.4 mg/dL, which reduced to 126.7mg/dL (p <0.0001) during Ramadan (first 7 days of fast). Mean glycaemic pattern demonstrated that time in target was 55.71% and 59.9% (p>0.05), while the time below target (predicting the probable risk of hypoglycaemia) was 10.2% and 16.6% (p = 0.007) before and during Ramadan respectively.
Conclusion: Results from this real world study showed that ABGM could be a guiding tool to adapt the overall diabetes management especially during Ramadan, including patient counselling and education on modification of lifestyle and medications, which has a favorable impact on glycaemic control as well as variability (including probability of hypoglycaemia), during Ramadan.
S.S. Shaikh: None. S.S. Shaikh: None.
