Literature DB >> 32152018

Efficacy and Safety of Use of the Fasting Algorithm for Singaporeans With Type 2 Diabetes (FAST) During Ramadan: A Prospective, Multicenter, Randomized Controlled Trial.

Zheng Kang Lum1, Zi Rui Khoo1, Wei Yann See Toh2, Shaikh Abdul Kader Kamaldeen, Abdul Shakoor3, Keith Yu Kei Tsou4, Daniel Ek Kwang Chew3, Rinkoo Dalan3, Sing Cheer Kwek4, Noorani Othman3, Joyce Xia Lian3, Raden Nurheryany Bte Sunari1, Joyce Yu-Chia Lee5,2.   

Abstract

PURPOSE: We aimed to evaluate the efficacy and safety of use of the Fasting Algorithm for Singaporeans with Type 2 Diabetes (FAST) during Ramadan.
METHODS: We performed a prospective, multicenter, randomized controlled trial. The inclusion criteria were age ≥21 years, baseline glycated hemoglobin (HbA1c) level ≤9.5%, and intention to fast for ≥10 days during Ramadan. Exclusion criteria included baseline estimated glomerular filtration rate <30 mL/min, diabetes-related hospitalization, and short-term corticosteroid therapy. Participants were randomized to intervention (use of FAST) or control (usual care without FAST) groups. Efficacy outcomes were HbA1c level and fasting blood glucose and postprandial glucose changes, and the safety outcome was incidence of major or minor hypoglycemia during the Ramadan period. Glycemic variability and diabetes distress were also investigated. Linear mixed models were constructed to assess changes.
RESULTS: A total of 97 participants were randomized (intervention: n = 46, control: n = 51). The HbA1c improvement during Ramadan was 4 times greater in the intervention group (-0.4%) than in the control group (-0.1%) (P = .049). The mean fasting blood glucose level decreased in the intervention group (-3.6 mg/dL) and increased in the control group (+20.9 mg/dL) (P = .034). The mean postprandial glucose level showed greater improvement in the intervention group (-16.4 mg/dL) compared to the control group (-2.3 mg/dL). There were more minor hypoglycemic events based on self-monitered blood glucose readings in the control group (intervention: 4, control: 6; P = .744). Glycemic variability was not significantly different between the 2 groups (P = .284). No between-group differences in diabetes distress were observed (P = .479).
CONCLUSIONS: Our findings emphasize the importance of efficacious, safe, and culturally tailored epistemic tools for diabetes management.
© 2020 Annals of Family Medicine, Inc.

Entities:  

Keywords:  HbA1c; Muslims; Ramadan; algorithm; diabetes distress; efficacy; fasting blood glucose; postprandial glucose; safety

Mesh:

Substances:

Year:  2020        PMID: 32152018      PMCID: PMC7062498          DOI: 10.1370/afm.2500

Source DB:  PubMed          Journal:  Ann Fam Med        ISSN: 1544-1709            Impact factor:   5.166


  29 in total

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Review 5.  The application of simple metrics in the assessment of glycaemic variability.

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6.  Impact of an individualized type 2 diabetes education program on clinical outcomes during Ramadan.

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7.  The effects of Ramadan fasting on sleep patterns and daytime sleepiness: An objective assessment.

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9.  Psychometric Properties of the Problem Areas in Diabetes (PAID) Instrument in Singapore.

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10.  Metabolic parameters in type 2 diabetic patients with varying degrees of glycemic control during Ramadan: An observational study.

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1.  Implications of the FAST Protocol Beyond Spirituality.

Authors:  Jonathan G Gabison
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2.  Impact of Ramadan Diurnal Intermittent Fasting on Hypoglycemic Events in Patients With Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials and Observational Studies.

Authors:  Dana Abdelrahim; MoezAlIslam E Faris; Mohamed Hassanein; Ayman Z Shakir; Ayesha M Yusuf; Aljohara S Almeneessier; Ahmed S BaHammam
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