Ramadan Fasting In Patients Research Articles

0241 : Does Ramadan fasting has any effects on hemoglobin, glucose and renal function in patients with chronic heart failure?

The effects of Islamic fasting on physiologic functions in normal conditions have been considered in different studies and different topics. This study was to determine the quantitative changes of hemoglobin, glucose and renal function during Ramadan fasting in patients with chronic heart failure. Fifty-three outpatients with chronic heart failure were followed in 2 stages: one week before the start of Ramadan and then on the last day of Ramadan by proper blood sampling in suitable time of day. There were 31 (58.5%) males and 22 (41.5%) females with a mean age of 60±11.06 years. Nineteen patients (35.8%) had mild left ventricular systolic dysfunction, 29 patients (54.7%) had moderate systolic dysfunction and 5 patients (9.4%) had severe systolic dysfunction. There were no significant changes in the NYHA Class nor there were any significant changes in the Canadian Cardiac Society (CCS) class in patients with coronary artery disease. We found non significant decrease in hemoglobin and blood glucose level ( P =0.76) and ( P =0.16) respectively, and non significant increase in creatinine ( P =0.07) before and at the end of Ramadan in either males or females. The conclusions from this study can not be extrapolated to patients with worse functional classes or those who are unstable. It is clear that more work should be carried out to evaluate the impact of fasting on cardiac patients with higher NYHA class, and discover the significance of Ramadan fasting in patients with heart disease.

Glucose excursions and glycaemic control during Ramadan fasting in diabetic patients: Insights from continuous glucose monitoring (CGM)

AimRamadan fasting represents a major shift in meal timing and content for practicing Muslims. This study used continuous glucose monitoring (CGM) to assess changes in markers of glycaemic excursions during Ramadan fasting to investigate the short-term safety of this practice in different groups of patients with diabetes. MethodsA total of 63 subjects (56 with diabetes, seven healthy volunteers; 39 male, 24 female) had CGM performed during, before and after Ramadan fasting. Mean CGM curves were constructed for each group for these periods that were then used to calculate indicators of glucose control and excursions. Post hoc data analyses included comparisons of different medication categories (metformin/no medication, gliptin, sulphonylurea and insulin). Medication changes during Ramadan followed American Diabetes Association guidelines. ResultAmong patients with diabetes, there was a significant difference in mean CGM curve during Ramadan, with a slow fall during fasting hours followed by a rapid rise in glucose level after the sunset meal (iftar). The magnitude of this excursion was greatest in the insulin-treated group, followed by the sulphonylurea-treated group. Markers of control deteriorated in a small number (n=3) of patients. Overall, whether fasting or non-fasting, subjects showed no statistically significant changes in mean interstitial glucose (IG), mean amplitude of glycaemic excursion (MAGE), high and low blood glucose indices (HBGI/LBGI), and number of glucose excursions and rate of hypoglycaemia. ConclusionThe main change in glycaemic control with Ramadan fasting in patients with diabetes is in the pattern of excursions. Ramadan fasting caused neither overall deterioration nor improvement in the majority of patients with good baseline glucose control.

Effect of Ramadan Fasting on Body Weight, (BP) and Biochemical Parameters in Middle Aged Hypertensive Subjects: An Observational Trial

Ramadan fasting is a religious obligation which is practised by Muslim population all over the world. However, there is scarcity of scientific literature regarding its effects on health determinants in cardiovascular disturbances like hypertension. The present study was done to assess the (BP), body weight and serum cholesterol changes over the period of Ramadan fasting in patients with hypertension. Materails And Methods:This prospective observational trial was done on 15 hypertensive subjects who were in the age group of 35 to 65 years, who were determined to complete Ramadan fast. All subjects were on antihypertensive therapy. Outcome measures of (BP), body weight and serum cholesterol were assessed in all the subjects before and after Ramadan month. Mean age of subjects was 44.6 ± 5.62 years. Systolic BP decreased from 148 ± 19.6 to 132.5 ± 17.9 mm of Hg. The decrease of 15.5 units (95% CI: 7.5 to 24.4) was statistically significant (p = 0.0009). Diastolic BP decreased from 90.4 ± 7.8 to 81.1 ± 6.3 mm of Hg. The decrease of 9.3 units (95% CI: 5.7 to 13) was statistically significant (p < 0.0001). There was statistically significant decrease in body weight from 66.6 ± 13 to 65.2 ± 12.7 kg (p < 0.0001). There was no significant difference in serum cholesterol from 187.3 ± 28.9 to 192.7 ± 31.3 mg% (p = 0.37). Hypertensive patients with continuation of their medicines showed a decrease in blood pressure and reduction in body weight at the end of Ramadan fasting duration. However there was no change found in serum cholesterol levels.

Ramadan fasting in patients with type 2 diabetes mellitus: Experience from a teaching hospital

Ramadan fasting in patients with type 2 diabetes mellitus: Experience from a teaching hospital

The effect of fasting in Ramadan on patients with heart disease

Background: Knowledge about the clinical problems during the fast of Ramadan is important in order to opens the way to further research aimed at discovering the significance of Ramadan fasting in patients with heart disease.Patients and Methods: Eighty-six outpatients with heart disease with intention to fast were studied in the month of Ramadan 2010 (1430 H) at the Ibn Al-bitar Hospital. Detailed clinical and biochemical assessments were performed within 3 days before the start of Ramadan and then on the last day of Ramadan.Results: There were 54 (62.8%) males and 32 (37.2%) females with a mean age of 56.3 years (range, 17-84 ). Forty-six patients (53%) had coronary artery disease, 23 patients (27%) had valvular heart disease, 13 patients (15%) had congestive heart failure and 4 patients (5%) were treated for arrhythmia. Sixty-two patients (72%) were in New York Heart Association (NYHA) Class I, 18 patients (21%) in Class II, and 6 patients (7%) were in Class III. Seventy-four patients (86%) managed to fast during the entire Ramadan, 9 patients (10.4%) missed the fasting for up to 7 days, and 3 patients (3.5%) could not fast. There were no significant changes in the NYHA Class (p=0.12). No significant changes occurred in any of the hematological or biochemical parameters during the fasting of Ramadan.Conclusion: The effects of fasting during Ramadan on stable patients with cardiac disease are minimal. The majority of patients with stable cardiac disease can fast during Ramadan without significant detrimental effects.

Metabolic and clinical effects of Ramadan fasting in patients with type II diabetes.

To evaluate the effects of fasting on anthropometric indices and carbohydrate and lipid metabolism in patients with type II diabetes. Observational non-interventional study. : Diabetes clinic, Shariati Hospital, Tehran, Iran during Ramadan 1419 (winter 1998-99). Fifty-seven volunteers with type II diabetes underwent anthropometric and biochemical evaluation before and on the 14th and 28th days of Ramadan. Biochemical markers were measured by standard laboratory methods and anthropometric indices by WHO criteria. Statistical analysis was done by ANOVA for repeated measurements and Friedman's two-way ANOVA using SPSSv6 software. Daily cholesterol intake increased in all subjects (p<0.03). Body mass index increased in women (p<0.03), but BMI and waist-hip ratio both decreased in men (p<0.01). Blood pressure, fasting blood glucose and serum fructosamine did not change during the study. Plasma insulin (p<0.05), C-peptide (p<0.01) and insulin resistance (p<0.01) decreased only in men. Total and LDL cholesterol increased significantly in all subjects during the study. Ramadan fasting does not alter carbohydrate metabolism or tissue insulin sensitivity in patients with type II diabetes given appropriate dietary education and rescheduling of oral hypoglycaemic medication. Lipid profile is unfavourably altered due to changes in both diet and biochemical response to starvation.

The decreasing effect of ramadan in acid secretion. “Does ramadan cause sham vagotomy?”

Ramadan fasting represents a major shift in meal timing and content for practicing Muslims. This study used continuous glucose monitoring (CGM) to assess changes in markers of glycaemic excursions during Ramadan fasting to investigate the short-term safety of this practice in different groups of patients with diabetes.A total of 63 subjects (56 with diabetes, seven healthy volunteers; 39 male, 24 female) had CGM performed during, before and after Ramadan fasting. Mean CGM curves were constructed for each group for these periods that were then used to calculate indicators of glucose control and excursions. Post hoc data analyses included comparisons of different medication categories (metformin/no medication, gliptin, sulphonylurea and insulin). Medication changes during Ramadan followed American Diabetes Association guidelines.Among patients with diabetes, there was a significant difference in mean CGM curve during Ramadan, with a slow fall during fasting hours followed by a rapid rise in glucose level after the sunset meal (iftar). The magnitude of this excursion was greatest in the insulin-treated group, followed by the sulphonylurea-treated group. Markers of control deteriorated in a small number (n = 3) of patients. Overall, whether fasting or non-fasting, subjects showed no statistically significant changes in mean interstitial glucose (IG), mean amplitude of glycaemic excursion (MAGE), high and low blood glucose indices (HBGI/LBGI), and number of glucose excursions and rate of hypoglycaemia.The main change in glycaemic control with Ramadan fasting in patients with diabetes is in the pattern of excursions. Ramadan fasting caused neither overall deterioration nor improvement in the majority of patients with good baseline glucose control.