PMID- 28685515
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 2093-596X (Print)
IS  - 2093-5978 (Electronic)
IS  - 2093-596X (Linking)
VI  - 32
IP  - 2
DP  - 2017 Jun
TI  - Predetermined Anti-Diabetic Drug Regimen Adjustments during Ramadan Fasting: An 
      Observational Study of Safety.
PG  - 265-273
LID - 10.3803/EnM.2017.32.2.265 [doi]
AB  - BACKGROUND: Many Muslim type 2 diabetes mellitus (T2DM) patients choose to fast 
      the month of Ramadan despite the possible adverse health effects brought about by 
      the change in dietary habits, among other things. Clinical data regarding the 
      safety of multi-drug regimens during fasting are particularly scarce. The aim of 
      the study was to evaluate the safety of a drug protocol devised by the authors to 
      accommodate Ramadan's dietary changes, involving dose adjustments of four 
      anti-diabetic drug regimens in T2DM patients fasting Ramadan. METHODS: In this 
      prospective, observational, open-label study, 301 T2DM patients who wished to 
      fast Ramadan were followed during Ramadan and the preceding month. The incidence 
      of hypoglycemia, diabetic ketoacidosis (DKA) and non-ketotic hyperosmolar state 
      (NKHS) was monitored. Patients were classified into four groups: A group (those 
      taking metformin, sulfonylurea and insulin [n=33]); B group (metformin and 
      sulfonylurea [n=89]); C group (metformin and insulin [n=96]); and D group 
      (premixed 70/30, glargine or regular insulin [n=82]). During Ramadan, drug doses 
      were adjusted as percentages of their pre-Ramadan values: 75% for sulfonylureas, 
      75% for glargine, 75% for premixed insulin 70/30 in two doses, and 75% for 
      regular insulin. Metformin was adjusted to a twice-daily regimen. RESULTS: No 
      cases of DKA or NKHS were reported. Hypoglycemia occurred at a lower rate than 
      pre-Ramadan values in groups C, and D; and a similar rate in groups A, and B. 
      CONCLUSION: The data suggested that using the above protocol to adjust the doses 
      of anti-diabetic drugs is safe in T2DM patients in regards to hypoglycemia, DKA, 
      and NKHS.
CI  - Copyright (c) 2017 Korean Endocrine Society
FAU - Beano, Abdallah M
AU  - Beano AM
AD  - Department of Internal Medicine, The University of Jordan School of Medicine, 
      Amman, Jordan.
FAU - Zmaili, Mohammad A
AU  - Zmaili MA
AD  - Department of Internal Medicine, The University of Jordan School of Medicine, 
      Amman, Jordan.
FAU - Gheith, Zaid H
AU  - Gheith ZH
AD  - Department of Internal Medicine, King Hussein Cancer Center (KHCC), Amman, 
      Jordan.
FAU - Naser, Ahmad M
AU  - Naser AM
AD  - Department of Internal Medicine, The University of Jordan School of Medicine, 
      Amman, Jordan.
FAU - Momani, Munther S
AU  - Momani MS
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, Jordan 
      University Hospital, The University of Jordan School of Medicine, Amman, Jordan.
FAU - Yousef, Al Motassem F
AU  - Yousef AMF
AD  - The University of Jordan Faculty of Pharmacy, Amman, Jordan.
FAU - Zayed, Ayman A
AU  - Zayed AA
AUID- ORCID: 0000-0001-6016-4769
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, Jordan 
      University Hospital, The University of Jordan School of Medicine, Amman, Jordan. 
      baraaayman@gmail.com.
LA  - eng
PT  - Journal Article
PL  - Korea (South)
TA  - Endocrinol Metab (Seoul)
JT  - Endocrinology and metabolism (Seoul, Korea)
JID - 101554139
PMC - PMC5503872
OTO - NOTNLM
OT  - Hypoglycemia
OT  - Insulin
OT  - Metformin
OT  - Ramadan
OT  - Sulfonylurea
COIS- No potential conflict of interest relevant to this article was reported.
EDAT- 2017/07/08 06:00
MHDA- 2017/07/08 06:01
PMCR- 2017/06/01
CRDT- 2017/07/08 06:00
PHST- 2017/01/09 00:00 [received]
PHST- 2017/03/28 00:00 [revised]
PHST- 2017/04/06 00:00 [accepted]
PHST- 2017/07/08 06:00 [entrez]
PHST- 2017/07/08 06:00 [pubmed]
PHST- 2017/07/08 06:01 [medline]
PHST- 2017/06/01 00:00 [pmc-release]
AID - 32.265 [pii]
AID - 10.3803/EnM.2017.32.2.265 [doi]
PST - ppublish
SO  - Endocrinol Metab (Seoul). 2017 Jun;32(2):265-273. doi: 10.3803/EnM.2017.32.2.265.