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Fasting during the holy month of Ramadan among older children and adolescents with type 1 diabetes in Kuwait.
J Pediatr Endocrinol Metab. 2019 Aug 27; 32(8):843-849.JP

Abstract

Background To evaluate the safety of fasting during the holy month of Ramadan among children and adolescent with type 1 diabetes (T1D). Methods A retrospective cohort study of 50 children and adolescents with T1D whose mean age was 12.7 ± 2.1 years was conducted. Twenty-seven patients (54%) were on multiple daily injections (MDI) insulin regimen and 23 (46%) were on insulin pump therapy. Before fasting for Ramadan, children and their families were evaluated and educated about diabetes management during Ramadan. Hemoglobin A1c (HbA1c), weight, number of days fasted, hypoglycemia and hyperglycemia episodes, and emergency hospital visits were collected and analyzed after completing the month. Participants were compared according to the insulin treatment regimen and their glycemic control level before Ramadan. Results The children were able to fast 20 ± 9.9 days of Ramadan, and the most common cause for breaking the fast was mild hypoglycemia (7.8% among all cases). There was no significant difference between the two insulin regimen groups in breaking fast days, frequency of hypo- or hyperglycemia, weight and HbA1c changes post Ramadan. Patients with HbA1c ≤ 8.5% were able to fast more days during Ramadan with significantly less-frequent hypoglycemic attacks as compared to patients with HbA1c > 8.5 (1.2 ± 1.5 vs. 3.3 ± 2.9 days of hypoglycemia, p = 0.01, respectively). Conclusions Fasting for children with T1D above the age of 10 years is feasible and safe in both pump and non-pump users, and well-controlled patients are less likely to develop complications. Education of the families and their children before Ramadan, along with intensive monitoring of fasting children during the month are crucial.

Authors+Show Affiliations

Pediatric Department at Mubarak Al Kabeer Hospital, Jabriya, Kuwait.College of Medicine, Kuwait University, Safat, Kuwait.Associate Professor of Public Health, College of Medicine, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, Saudi Arabia.Pediatric Department at Mubarak Al Kabeer Hospital, Jabriya, Kuwait.Pediatric Department at Mubarak Al Kabeer Hospital, Jabriya, Kuwait.College of Medicine, Kuwait University, Safat, Kuwait.Research Division, Dasman Diabetes Institute, Al Kuwayt, Kuwait.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31318694

Citation

Mohamed, Kholoud, et al. "Fasting During the Holy Month of Ramadan Among Older Children and Adolescents With Type 1 Diabetes in Kuwait." Journal of Pediatric Endocrinology & Metabolism : JPEM, vol. 32, no. 8, 2019, pp. 843-849.
Mohamed K, Al-Abdulrazzaq D, Fayed A, et al. Fasting during the holy month of Ramadan among older children and adolescents with type 1 diabetes in Kuwait. J Pediatr Endocrinol Metab. 2019;32(8):843-849.
Mohamed, K., Al-Abdulrazzaq, D., Fayed, A., El Busairi, E., Al Shawaf, F., Abdul-Rasoul, M., & Shaltout, A. A. (2019). Fasting during the holy month of Ramadan among older children and adolescents with type 1 diabetes in Kuwait. Journal of Pediatric Endocrinology & Metabolism : JPEM, 32(8), 843-849. https://doi.org/10.1515/jpem-2019-0009
Mohamed K, et al. Fasting During the Holy Month of Ramadan Among Older Children and Adolescents With Type 1 Diabetes in Kuwait. J Pediatr Endocrinol Metab. 2019 Aug 27;32(8):843-849. PubMed PMID: 31318694.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fasting during the holy month of Ramadan among older children and adolescents with type 1 diabetes in Kuwait. AU - Mohamed,Kholoud, AU - Al-Abdulrazzaq,Dalia, AU - Fayed,Amel, AU - El Busairi,Eman, AU - Al Shawaf,Faisal, AU - Abdul-Rasoul,Majedah, AU - Shaltout,Azza A, PY - 2019/01/06/received PY - 2019/06/02/accepted PY - 2019/7/19/pubmed PY - 2020/1/24/medline PY - 2019/7/19/entrez KW - Kuwait KW - Ramadan KW - adolescence KW - children KW - fasting KW - type 1 diabetes mellitus SP - 843 EP - 849 JF - Journal of pediatric endocrinology & metabolism : JPEM JO - J Pediatr Endocrinol Metab VL - 32 IS - 8 N2 - Background To evaluate the safety of fasting during the holy month of Ramadan among children and adolescent with type 1 diabetes (T1D). Methods A retrospective cohort study of 50 children and adolescents with T1D whose mean age was 12.7 ± 2.1 years was conducted. Twenty-seven patients (54%) were on multiple daily injections (MDI) insulin regimen and 23 (46%) were on insulin pump therapy. Before fasting for Ramadan, children and their families were evaluated and educated about diabetes management during Ramadan. Hemoglobin A1c (HbA1c), weight, number of days fasted, hypoglycemia and hyperglycemia episodes, and emergency hospital visits were collected and analyzed after completing the month. Participants were compared according to the insulin treatment regimen and their glycemic control level before Ramadan. Results The children were able to fast 20 ± 9.9 days of Ramadan, and the most common cause for breaking the fast was mild hypoglycemia (7.8% among all cases). There was no significant difference between the two insulin regimen groups in breaking fast days, frequency of hypo- or hyperglycemia, weight and HbA1c changes post Ramadan. Patients with HbA1c ≤ 8.5% were able to fast more days during Ramadan with significantly less-frequent hypoglycemic attacks as compared to patients with HbA1c > 8.5 (1.2 ± 1.5 vs. 3.3 ± 2.9 days of hypoglycemia, p = 0.01, respectively). Conclusions Fasting for children with T1D above the age of 10 years is feasible and safe in both pump and non-pump users, and well-controlled patients are less likely to develop complications. Education of the families and their children before Ramadan, along with intensive monitoring of fasting children during the month are crucial. SN - 2191-0251 UR - https://www.unboundmedicine.com/medline/citation/31318694/Fasting_during_the_holy_month_of_Ramadan_among_older_children_and_adolescents_with_type_1_diabetes_in_Kuwait_ L2 - https://www.degruyter.com/document/doi/10.1515/jpem-2019-0009 DB - PRIME DP - Unbound Medicine ER -