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Diabetes and Ramadan: Utility of flash-glucose monitoring derived markers of glycaemic control and comparison with glycosylated haemoglobin

Published on Jul 1, 2019in Diabetes Research and Clinical Practice3.239
· DOI :10.1016/j.diabres.2019.05.020
Ilham Saadane1
Estimated H-index: 1
(Imperial College London),
Tanveer Ashraf (Imperial College London)+ 1 AuthorsNader Lessan8
Estimated H-index: 8
(Imperial College London)
Source
Abstract
Abstract Aims Flash glucose monitoring (FGM)-derived markers of glucose control and variability and laboratory measured HbA1c among patients with diabetes on insulin in context of Ramadan fasting (RF) were examined and compared. Methods FGM data on insulin-treated patients (n = 20, age 42.3 ± 11.4 years; 18 male, 2 female; 13 with type 1 and 7 with type 2 diabetes) who fasted during Ramadan were used to calculate Q-score as an indicator of glycaemia before, during and after RF. Post-hoc analysis in a group of patients (n = 12) who had HbA1c available and appropriate for these periods was performed. Other relevant data were extracted from patient records. Results Mean glucose (9.6 ± 1.32 v 10.78 ± 1.64 mmol/l; P  Conclusions Ramadan fasting was associated with a deterioration in overall glucose control and time in hyperglycaemia in insulin-treated patients. FGM-derived markers are useful and a preferable alternative to HbA1c in Ramadan studies.
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References35
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#2Roy W. BeckH-Index: 83
Last. William T. Cefalu (American Diabetes Association)H-Index: 5
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While A1C is well established as an important risk marker for diabetes complications, with the increasing use of continuous glucose monitoring (CGM) to help facilitate safe and effective diabetes management, it is important to understand how CGM metrics, such as mean glucose, and A1C correlate. Estimated A1C (eA1C) is a measure converting the mean glucose from CGM or self-monitored blood glucose readings, using a formula derived from glucose readings from a population of individuals, into an est...
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#1Mohammed Bakri Bashir (Hamad Medical Corporation)H-Index: 6
#2Tarik Elhadd (Hamad Medical Corporation)H-Index: 3
Last. Abdul-Badie Abou-Samra (Hamad Medical Corporation)H-Index: 3
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Abstract Background This study aims to examine the incidence of hypoglycaemia, based on activity, during Ramadan in patients with type 2 diabetes mellitus who were on were on three or more anti-diabetic medications. Methods Type 2 diabetes patients who fasted during Ramadan and were on three or more anti-diabetic medications were studied for two weeks using flash glucose monitoring. The patients were asked to document all episodes of hypoglycaemia and were classified as active or sedentary accor...
3 CitationsSource
#1M. AbidH-Index: 23
#2Mohamed HsairiH-Index: 1
Last. Emna Ben AissaH-Index: 1
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Aim: To estimate the proportion of diabetic patients on insulin, who interrupt fasting during Ramadan, and describe the reported reasons of this interruption. Design: This is a national observational survey of diabetic patients treated with insulin and fasting during the month of Ramadan 2013, proposed to all endocrinologists willing to participate. Consecutive patients were included until the required sample size, estimated at 498 patients, was obtained. Conducted among patients recruited by en...
2 CitationsSource
Objectives: The objective of this study is to assess the frequency, timing, and severity of hypoglycemia in adolescents with type 1 diabetes mellitus (T1DM) during fasting the month of Ramadan. Patients and Methods: Twenty-five adolescents with T1DM who fasted Ramadan were monitored using the FreeStyle Libre® flash glucose monitoring (FGM) system. Percentage and total duration of hypoglycemia were extracted from the FGM downloads, and the differences were compared between different times of the ...
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#1Walid KaplanH-Index: 4
#2Bachar AfandiH-Index: 10
Last. Taoufik Zoubeidi (United Arab Emirates University)H-Index: 11
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Abstract Aim To assess the impact of fasting on interstitial glucose (IG) in adolescents with type 1 DM (T1DM) by using continuous glucose monitoring (CGM). Method A minimum of 2.5 days CGM was done on adolescents with T1DM during fasting in Ramadan and in the month before or after Ramadan to compare the differences in mean IG, and in the durations of hypoglycemia ( Results Fourteen adolescents were studied, age 15 ± 4 years, duration of diabetes 6 ± 4 years, and HbA1C 8.6 ± 1.1% (70.3 mmol/mol)...
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#1DanneThomasH-Index: 33
#2Revital Nimri (SARA: San Antonio River Authority)H-Index: 20
Last. Moshe Phillip (SARA: San Antonio River Authority)H-Index: 7
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Measurement of glycated hemoglobin (HbA 1c ) has been the traditional method for assessing glycemic control. However, it does not reflect intra- and interday glycemic excursions that may lead to acute events (such as hypoglycemia) or postprandial hyperglycemia, which have been linked to both microvascular and macrovascular complications. Continuous glucose monitoring (CGM), either from real-time use (rtCGM) or intermittently viewed (iCGM), addresses many of the limitations inherent in HbA 1c tes...
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#1B HirschIrl (UW: University of Washington)H-Index: 63
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#1Abdul Jabbar (Eli Lilly and Company)H-Index: 4
#2Mohamed Hassanein (Dubai Health Authority)H-Index: 5
Last. Steven M. Babineaux (Eli Lilly and Company)H-Index: 6
view all 6 authors...
Abstract Aims To describe diabetes treatment and hypoglycaemia in individuals with Type 2 diabetes mellitus during Ramadan. Methods A multi-country, retrospective, observational study with data captured before, during, and after Ramadan. We report on a cohort of people (N = 3250) with Type 2 diabetes mellitus in four culturally distinct regions: Asia, North Africa, Europe, and the Middle East. Results During Ramadan, the proportion of participants on oral anti-diabetic medication alone ranged fr...
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Abstract Supplementary Table S1 Continuous Glucose Monitoring (CGM) has been demonstrated to be clinically valuable, reducing risks of hypoglycemia and hyperglycemia, glycemic variability (GV), and improving patient quality of life for a wide range of patient populations and clinical indications. Use of CGM can help reduce HbA1c and mean glucose. One CGM device, with accuracy (%MARD) of approximately 10%, has recently been approved for self-adjustment of insulin dosages (nonadjuvant use) and app...
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Abstract Background: Hemoglobin A1c is an excellent population health measure for the risk of vascular complications in diabetes, while continuous glucose monitoring (CGM) is a tool to help personalize a diabetes treatment plan. The value of CGM in individuals with type 1 diabetes (T1D) has been well demonstrated when compared with utilizing self-monitoring of blood glucose (SMBG) to guide treatment decisions. CGM is a tool for patients and clinicians to visualize the important role that diet, e...
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