Literature DB >> 21159037

Safety and tolerability of once or twice daily neutral protamine hagedorn insulin in fasting pregnant women with diabetes during Ramadan.

Mohamed I Nor Azlin1, Rohaida Adam, Seri S Sufian, Norashikin A Wahab, Norlaila Mustafa, Nor A Kamaruddin, Muhammad A Jamil.   

Abstract

AIM: To evaluate the safety and tolerability of once or twice daily neutral protamine hagedorn (NPH) insulin in fasting pregnant diabetics during Ramadan.
METHODS: This was a prospective cohort study conducted during Ramadan 2006 and 2007. Twenty four pregnant diabetic women were given NPH insulin once at 5 pm or twice daily at 5 pm and 5 am. Demographic data, blood glucose control, insulin requirement, days of fasting and hypoglycemic episodes were analyzed.
RESULTS: Most women were parity 1 (37.5%) in their second trimester (54.2%) and worked during the daytime (87.5%). Fourteen women (58.3%) had gestational diabetes mellitus, nine women (37.5%) had type 2 and one (4.2%) had type 1 diabetes mellitus. There were significant reductions in mean fasting blood glucose (6.16 mmol/L versus 5.34 mmol/L, P = 0.001), glycosylated hemoglobin (HbA1c) (6.70% ± 0.91 versus 6.64% ± 0.96, P = 0.001) and serum fructosamine (232.4 mmol/L ± 24.0 versus 217.0 mmol/L ± 24.3, P = 0.001) after Ramadan compared to before Ramadan. Throughout the four weeks of Ramadan, home blood glucose monitoring showed a reducing trend and was within the acceptable limits. Insulin requirement was increased from the first to the fourth week with a reduction in insulin dose noted after (38.5 U/day) compared to before the start of Ramadan (40 U/day). Most women (79.2%) were able to fast for more than 15 days without any hypoglycemia or fetal demise.
CONCLUSION: Once or twice daily NPH insulin is a safe and tolerable option for pregnant diabetics who wish to fast during Ramadan.
© 2010 The Authors. Journal of Obstetrics and Gynaecology Research © 2010 Japan Society of Obstetrics and Gynecology.

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Year:  2010        PMID: 21159037     DOI: 10.1111/j.1447-0756.2010.01330.x

Source DB:  PubMed          Journal:  J Obstet Gynaecol Res        ISSN: 1341-8076            Impact factor:   1.730


  4 in total

Review 1.  Ramadan Fasting and Maternal and Fetal Outcomes in Pregnant Women with Diabetes Mellitus: Literature Review.

Authors:  Shejil Kumar; Terrence Diamond
Journal:  Front Endocrinol (Lausanne)       Date:  2022-06-24       Impact factor: 6.055

Review 2.  Review of insulin-associated hypoglycemia and its impact on the management of diabetes in Southeast Asian countries.

Authors:  Su-Yen Goh; Zanariah Hussein; Achmad Rudijanto
Journal:  J Diabetes Investig       Date:  2017-05-04       Impact factor: 4.232

3.  Fructosamine as an Index of Short-Term Glycemic Control in Pregnant Women with Diabetes: Before, During and After Ramadan.

Authors:  Aishah Ekhzaimy; Shadin Alkatari; Mohamed AlMaatouq; Daad Alotaibi; Sarah Aljasser; Amal Aseeri; Anwar Jammah; Muhammad Mujammami; Mona Fouda; Assim A Alfadda; Riad Sulaimani
Journal:  Int J Womens Health       Date:  2022-03-30

4.  Glycemic Control among Pregnant Diabetic Women on Insulin Who Fasted During Ramadan.

Authors:  Nor Azlin Mohamed Ismail; Hadijat Olaide Raji; Norashikin Abd Wahab; Norlaila Mustafa; Nor Azmi Kamaruddin; Muhammad Abdul Jamil
Journal:  Iran J Med Sci       Date:  2011-12
  4 in total

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