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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma


IMPACT FACTOR 2018: 1.239

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SCImago Journal Rank (SJR) 2018: 0.507
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2191-0251
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Volume 29, Issue 5

Issues

Safety and metabolic impact of Ramadan fasting in children and adolescents with type 1 diabetes

Amany El-Hawary
  • Endocrinology and Diabetes Unit, Faculty of Medicine, Pediatrics Department, Mansoura University, Mansoura, Egypt
  • Other articles by this author:
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/ Nanees Salem
  • Corresponding author
  • Endocrinology and Diabetes Unit, Faculty of Medicine, Pediatrics Department, Mansoura University, Mansoura, Egypt
  • Email
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/ Ashraf Elsharkawy
  • Endocrinology and Diabetes Unit, Faculty of Medicine, Pediatrics Department, Mansoura University, Mansoura, Egypt
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/ Abdelhameed Metwali
  • Endocrinology and Diabetes Unit, Faculty of Medicine, Internal medicine Department, Mansoura University, Mansoura, Egypt
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/ Alaa Wafa
  • Endocrinology and Diabetes Unit, Faculty of Medicine, Internal medicine Department, Mansoura University, Mansoura, Egypt
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/ Nehad Chalaby
  • Endocrinology and Diabetes Unit, Faculty of Medicine, Pediatrics Department, Mansoura University, Mansoura, Egypt
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/ Abelhady El-Gilany / Megahed Abo-Elmagd
  • Endocrinology and Diabetes Unit, Faculty of Medicine, Internal medicine Department, Mansoura University, Mansoura, Egypt
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/ Magdy El-Ziny
  • Endocrinology and Diabetes Unit, Faculty of Medicine, Pediatrics Department, Mansoura University, Mansoura, Egypt
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Published Online: 2016-02-27 | DOI: https://doi.org/10.1515/jpem-2015-0263

Abstract

Background: Annually, many children and adolescents with type 1 diabetes mellitus (T1DM) insist on fasting for Ramadan despite being exempted and despite knowing all the risks. We aimed to assess the safety and metabolic impact of Ramadan fasting in children with T1DM using different insulin regimens.

Methods: Children with T1DM who choose to fast during Ramadan 1434/2013 (29 days) were recruited 3 months before Ramadan. They received pre-Ramadan intensive education. Three insulin regimens were included; Regimen-I (regular insulin/NPH); Regimen-II (regular insulin/insulin glargine) and Regimen-III (premixed insulin). Changes in weight, insulin dose, HbA1c, fructosamine and lipid profile were evaluated.

Results: Out of total 53 patients (24 male), 28 patients (52.8%) completed Ramadan fasting (fasting group). The remaining 25 patients were included in (broke-fasting group). Positive correlation between fructosamine changes and number of days fasted during Ramadan. Significant decrease in post-Ramadan fructosamine (<0.001) and increase in post-Ramadan total cholesterol and low density lipoprotein (LDL) levels were detected within fasting, broke-fasting and insulin regimen groups. Significant higher blood glucose at three time points, pre-Iftar, pre-Sohur and midday in Regimen-I compared to Regimen-II and Regimen-III (p=0.004).

Conclusions: Fasting during Ramadan is feasible and is associated with significant improvement in fructosamine level in children with T1DM using different insulin regimens. Mandatory consideration to the quality and quantity of food offered to patients with T1DM during Ramadan to guard against adverse changes in lipid profile.

Keywords: insulin regimens; Ramadan fasting; type 1 diabetes

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About the article

Corresponding author: Nanees Salem, MD, Endocrinology and Diabetes Unit, Faculty of Medicine, Pediatrics Department, Mansoura University, 35516, Mansoura, Egypt, Phone: +201007553665, Fax: +2050 223 4092, E-mail:


Received: 2015-07-01

Accepted: 2016-01-04

Published Online: 2016-02-27

Published in Print: 2016-05-01


Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 29, Issue 5, Pages 533–541, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2015-0263.

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