The Effect of Self Glucose Monitoring on Glycemic Control of Patients with Diabetes Mellitus Fasting During Ramadan

Abstract

Background: It is known that a significant number of patients with diabetes insist on fasting in the month of Ramadan, despite the advice of their physicians and reliable authorities. In order to provide the best possible care and support to these patients, the International Diabetes Federation (IDF) and the Diabetes and Ramadan (DAR) International Alliance created practical guidelines. The aim of this study was to investigate the effect of consulting a physician and glucose self-monitoring on diabetes management during Ramadan in patients with fasting diabetes. Methods: With this retrospective observational study, patients over 18 years of age who were diagnosed with diabetes, who came to the diabetes outpatient clinic for control after Ramadan and who made their follow-up from our outpatient clinic before Ramadan, were included. Participants intending to fast (previous or not) were asked about previous fasting experiences, questions about whether they consulted the doctor before Ramadan, and for those who fasted, how they spent this Ramadan. The biochemical data of fasting patients before and after Ramadan were analyzed. Results: A total of 394 patients with diabetes participated in the questionnaire and 98 of them (24.9 %) who were fasted were included in the study. The mean age of the fasting patients with diabetes was 59.7 ± 12.3 years and39.2 %were female. It was detected that 86.7% of the fasting people were fasting for more than 15 days. Fasting rates were higher in males than females (32.4% to 20.8%). It was found that 25.9% of patients with type 2 DM and 10.3% of patients with type 1 DM were fasting. It was determined that 62.8% of the patients intending to fast were consulted to the physician about this subject, 55.3% of them were determined risk by physician and 70% of them followed up with self monitoring blood glucose (SMBG).It was determined that 23.4% (23/98) of fasting patients had a reduction in the number or dose of diabetes medications used; 5.1% (5/98) experienced a complication that would disrupt fasting; 16.3% gained weight (2.8 ± 2.4 kg) and 23.5% lost weight (2.7 ± 1.9 kg). A significant increase in HbA1c and a significant decrease in UACR were detected. It has been determined that A1c control of those who follow with SMBG is better protected than those who do not. Conclusion: In our study, it was seen that a quarter of patients with diabetes fasted. The most valuable result of this study is that the diabetic patients have achieved a more successful diabetes control by providing auto control mechanisms with SMBG, regardless of whether or not they have received medical advice by physician consultation during the Ramadan period.