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Impact of Ramadan focused education program on hypoglycemic risk and metabolic control for patients with type 2 diabetes

机译：斋月集中教育计划对2型糖尿病患者降糖风险和代谢控制的影响

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Background: Fasting during the month of Ramadan could lead to acute complications and increased hypoglycemic risk of patients with type 2 diabetes. Therefore, diabetes is one of the diseases that need careful observation and special considerations during Ramadan including patients’ education and counseling. Objectives: To evaluate the impact of Ramadan focused education program on acute complications and biomedical parameters. Methods: A prospective nonrandomized interventional controlled design was run on three phases: before, during, and after Ramadan on 262 type 2 diabetes patients. The intervention group (n=140) received focused individualized diabetic education sessions and antidiabetic medications adjustment before and after Ramadan, while the control group (n=122) received standard diabetic care. A validated hypoglycemia questionnaire was used in both groups to assess the change of the risk. Patients were advised to adjust the dosage and timing of antidiabetic agents according to the recommendations for management of diabetes during Ramadan. Primary outcomes were postintervention change of hypoglycemia score and HbA1c over 6-month follow-up. Data were presented as mean ± standard deviation. HbA1c was expressed in percentage. Results: The hypoglycemic scores before, during, and after Ramadan were 14.21±8.50, 6.36±6.17, and 5.44±5.55 in the intervention group, respectively ( P <0.001) and 14.01±5.10, 13.46±5.30, and 9.27±4.65 in the control group, respectively ( P <0.001). HbA1c levels were 9.79±1.89, 8.26±1.54, and 8.52±1.61 before, during, and after Ramadan in the intervention group, respectively ( P <0.001), and 10.04±1.47, 9.54±1.38, and 9.59±1.79 in the control group, respectively ( P <0.001). Post-Ramadan reductions of HbA1c and hypoglycemic scores were significantly higher in the intervention group (-13.0% vs -4.5%, P =0.004 for HbA1c and -61.7% vs -33.8%, P <0.001 for hypoglycemic score). Low-density lipoprotein cholesterol improved in the intervention group from 2.41±0.91 mmol/L before Ramadan to 2.28±0.68 mmol/L after Ramadan ( P <0.001). No statistically significant effects were observed on blood pressure or body weight in the intervention group. Also, no change was observed in the control group. Conclusion: Ramadan educational program had a positive impact with reduction of hypoglycemic risk, HbA1c, and low-density lipoprotein cholesterol. Therefore, it could be recommended for patients with increased risk of hypoglycemia during Ramadan fasting.
机译：背景：斋月期间的空腹可能导致2型糖尿病患者的急性并发症和降血糖的风险增加。因此，在斋月期间，糖尿病是需要认真观察和特殊考虑的疾病之一，包括患者的教育和咨询。目的：评估斋月重点教育计划对急性并发症和生物医学参数的影响。方法：前瞻性非随机介入控制设计在262个2型糖尿病患者的斋月之前，期间和之后的三个阶段进行。干预组（n = 140）在斋月前后接受了有针对性的个性化糖尿病教育会议和抗糖尿病药物调整，而对照组（n = 122）接受了标准的糖尿病护理。两组均使用经过验证的低血糖问卷来评估风险的变化。建议患者根据斋月期间糖尿病管理的建议调整抗糖尿病药的剂量和时机。主要结局是干预后6个月的低血糖评分和HbA1c的变化。数据表示为平均值±标准偏差。 HbA1c以百分比表示。结果：干预组在斋月之前，期间和之后的降血糖评分分别为14.21±8.50、6.36±6.17和5.44±5.55（P <0.001）和14.01±5.10、13.46±5.30和9.27±4.65。对照组（P <0.001）。干预组斋月之前，期间和之后的H​​bA1c水平分别为9.79±1.89、8.26±1.54和8.52±1.61（P <0.001），对照组为10.04±1.47、9.54±1.38和9.59±1.79组分别（P <0.001）。斋戒月后HbA1c的降低和低血糖评分明显高于干预组（HbA1c的-13.0％vs -4.5％，P = 0.004;低血糖评分的-61.7％vs -33.8％，P <0.001）。干预组低密度脂蛋白胆固醇水平从斋月前的2.41±0.91 mmol / L提高到斋月后的2.28±0.68 mmol / L（P <0.001）。在干预组中未观察到对血压或体重的统计学显着影响。另外，在对照组中未观察到变化。结论：斋月教育计划对降低低血糖风险，HbA1c和低密度脂蛋白胆固醇具有积极影响。因此，建议斋月期间空腹时低血糖风险增加的患者。

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