Elamin Abdelgadir1, Fauzia Rashid2, Alaaeldin Bashier3, Maryam Al Saeed4, Azza Khalifa5, Fatheya Alawadi6, Mohamed Hassanein7. 1. Endocrine Department, Dubai Hospital, United Arab Emirates. Electronic address: alaminibrahim@hotmail.com. 2. Endocrine Department, Dubai Hospital, United Arab Emirates. Electronic address: FRashid@dha.gov.ae. 3. Endocrine Department, Dubai Hospital, United Arab Emirates. Electronic address: aeKhidir@dha.gov.ae. 4. Endocrine Department, Dubai Hospital, United Arab Emirates. Electronic address: AAlSaeed@dha.gov.ae. 5. Endocrine Department, Dubai Hospital, United Arab Emirates. Electronic address: AABinHussain@dha.gov.ae. 6. Endocrine Department, Dubai Hospital, United Arab Emirates. Electronic address: ffAlawadi@dha.gov.ae. 7. Endocrine Department, Dubai Hospital, United Arab Emirates. Electronic address: MMHassanein@dha.gov.ae.
Abstract
BACKGROUND: The risks of hypoglycemia, dehydration and kidney injury may theoretically be aggravated by people with type 2 diabetes treated with Insulin and SGLT2 inhibitors during Ramadan. Data on safety and efficacy of SGLT2-I in people with type 2 diabetes treated with insulin is scanty. We aimed to assess the impact of SGLT2 inhibitors during Ramadan in high-risk patients with type 2 diabetes treated with insulin, on hypoglycemia, glycemic control and kidney function. METHODS: This is a prospective interventional study on high-risk diabetes patients who insisted on fasting. All patients were treated with insulin ± SGLT2I. All patients received a FGMS and Ramadan focused education. All patients attended clinic before and post Ramadan where they were advised on treatment modification as well as biometric and biochemical measurements. RESULTS: 95 patients enrolled in the study and 49 of them were on SGLT2i. There was a no significant change in creatinine in both groups. FGMS showed an improvement in the sensor-calculated HbA1c from 7.3 ± 1.5 to 6.8 ± 1.1 and from 8 ± 1.6 to 7.7 ± 1.5 in the SGLT2 group and the non-SGT2i groups, respectively. The hypoglycemia was predominantly reported during Ramadan between 12:00 to 18:00 h, while in pre-Ramadan readings was during 2400-0600 and 1200-1800 slots. CONCLUSIONS: This is the first study that assesses the use of SGLT2i along with insulin during Ramadan, using FGMS in high-risk patients with type 2 diabetes under optimal care. There was minimal interruption of fasting, significant improvement in glycemic control, and no significant change in the kidney function after Ramadan.
BACKGROUND: The risks of hypoglycemia, dehydration and kidney injury may theoretically be aggravated by people with type 2 diabetes treated with Insulin and SGLT2 inhibitors during Ramadan. Data on safety and efficacy of SGLT2-I in people with type 2 diabetes treated with insulin is scanty. We aimed to assess the impact of SGLT2 inhibitors during Ramadan in high-risk patients with type 2 diabetes treated with insulin, on hypoglycemia, glycemic control and kidney function. METHODS: This is a prospective interventional study on high-risk diabetespatients who insisted on fasting. All patients were treated with insulin ± SGLT2I. All patients received a FGMS and Ramadan focused education. All patients attended clinic before and post Ramadan where they were advised on treatment modification as well as biometric and biochemical measurements. RESULTS: 95 patients enrolled in the study and 49 of them were on SGLT2i. There was a no significant change in creatinine in both groups. FGMS showed an improvement in the sensor-calculated HbA1c from 7.3 ± 1.5 to 6.8 ± 1.1 and from 8 ± 1.6 to 7.7 ± 1.5 in the SGLT2 group and the non-SGT2i groups, respectively. The hypoglycemia was predominantly reported during Ramadan between 12:00 to 18:00 h, while in pre-Ramadan readings was during 2400-0600 and 1200-1800 slots. CONCLUSIONS: This is the first study that assesses the use of SGLT2i along with insulin during Ramadan, using FGMS in high-risk patients with type 2 diabetes under optimal care. There was minimal interruption of fasting, significant improvement in glycemic control, and no significant change in the kidney function after Ramadan.
Authors: Dana Abdelrahim; MoezAlIslam E Faris; Mohamed Hassanein; Ayman Z Shakir; Ayesha M Yusuf; Aljohara S Almeneessier; Ahmed S BaHammam Journal: Front Endocrinol (Lausanne) Date: 2021-03-08 Impact factor: 5.555