Yanli Shao1, Gwyneth Joy Lim2, Chin Lian Chua3, Yip Fong Wong3, Ester Chai Kheng Yeoh3, Serena Kiat Mun Low4, Chee Fang Sum3. 1. Diabetes Centre, Admiralty Medical Centre (Khoo Teck Puat Hospital), Level 4, Kampung Admiralty, Blk 676, Woodlands Drive 71, S730676, Singapore. Electronic address: shao.yan.li@ktph.com.sg. 2. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. 3. Diabetes Centre, Admiralty Medical Centre and Khoo Teck Puat Hospital, Singapore. 4. Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
Abstract
OBJECTIVE: The effect of Ramadan fasting and continuing sodium-glucose co-transporter-2 (SGLT2) inhibitor use on ketonemia, blood pressure and renal function in Muslim patients with type 2 diabetes. METHODS: This is a single-centre prospective observational controlled cohort study. Muslim patients aged 21-75 years with type 2 diabetes and estimated glomerular filtration rate (eGFR) ≥ 45 ml/min/1.73 m2 were eligible if they had no contraindication to observe Ramadan fasting. Patients in study group were on stable dose of SGLT2 inhibitor for at least 3 months before enrolment and continued during study period, while patients in control group were not on SGLT2 inhibitor before and during study period. All participants attended baseline visit before Ramadan and follow-up visit during Ramadan. RESULTS: A total of 68 patients of similar baseline characteristics were included in the study: 35 in study group and 33 in control group. During Ramadan fasting, patients from study and control group had similar change in weight (LS mean change of -1.8 versus -1.1 kg, p = 0.205), eGFR (LS mean change of -6.0 versus -4.2 ml/min/1.73 m2, p = 0.399), sitting systolic BP (LS mean change of -8.1 versus -10.4 mmHg, p = 0.569), sitting diastolic BP (LS mean change of -3.7 versus -3.5 mmHg, p = 0.934) and plasma β-hydroxybutyrate level (LS mean change of -0.01 versus -0.02 mmol/L, p = 0.649). CONCLUSIONS: Ramadan fasting was associated with significant changes in weight, BP and eGFR regardless whether patients were on SGLT2 inhibitor treatment. Continued use of SGLT2 Inhibitors during Ramadan did not increase ketonemia, nor increase risk of eGFR deterioration and hypoglycaemia.
OBJECTIVE: The effect of Ramadan fasting and continuing sodium-glucose co-transporter-2 (SGLT2) inhibitor use on ketonemia, blood pressure and renal function in Muslim patients with type 2 diabetes. METHODS: This is a single-centre prospective observational controlled cohort study. Muslim patients aged 21-75 years with type 2 diabetes and estimated glomerular filtration rate (eGFR) ≥ 45 ml/min/1.73 m2 were eligible if they had no contraindication to observe Ramadan fasting. Patients in study group were on stable dose of SGLT2 inhibitor for at least 3 months before enrolment and continued during study period, while patients in control group were not on SGLT2 inhibitor before and during study period. All participants attended baseline visit before Ramadan and follow-up visit during Ramadan. RESULTS: A total of 68 patients of similar baseline characteristics were included in the study: 35 in study group and 33 in control group. During Ramadan fasting, patients from study and control group had similar change in weight (LS mean change of -1.8 versus -1.1 kg, p = 0.205), eGFR (LS mean change of -6.0 versus -4.2 ml/min/1.73 m2, p = 0.399), sitting systolic BP (LS mean change of -8.1 versus -10.4 mmHg, p = 0.569), sitting diastolic BP (LS mean change of -3.7 versus -3.5 mmHg, p = 0.934) and plasma β-hydroxybutyrate level (LS mean change of -0.01 versus -0.02 mmol/L, p = 0.649). CONCLUSIONS: Ramadan fasting was associated with significant changes in weight, BP and eGFR regardless whether patients were on SGLT2 inhibitor treatment. Continued use of SGLT2 Inhibitors during Ramadan did not increase ketonemia, nor increase risk of eGFR deterioration and hypoglycaemia.
Authors: Syed H Ahmed; Tahseen A Chowdhury; Sufyan Hussain; Ateeq Syed; Ali Karamat; Ahmed Helmy; Salman Waqar; Samina Ali; Ammarah Dabhad; Susan T Seal; Anna Hodgkinson; Shazli Azmi; Nazim Ghouri Journal: Diabetes Ther Date: 2020-09-09 Impact factor: 2.945
Authors: Mahmoud Ibrahim; Melanie J Davies; Ehtasham Ahmad; Firas A Annabi; Robert H Eckel; Ebtesam M Ba-Essa; Nuha Ali El Sayed; Amy Hess Fischl; Pamela Houeiss; Hinde Iraqi; Ines Khochtali; Kamlesh Khunti; Shabeen Naz Masood; Safia Mimouni-Zerguini; Samad Shera; Jaakko Tuomilehto; Guillermo E Umpierrez Journal: BMJ Open Diabetes Res Care Date: 2020-05