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Baharuddin B, Wijaya A. Metabolism and diabetes in Ramadan fasting: Exploring health trends and relationships through systematic literature network analysis. NARRA J 2024; 4:e850. [PMID: 39280308 PMCID: PMC11392000 DOI: 10.52225/narra.v4i2.850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 07/08/2024] [Indexed: 09/18/2024]
Abstract
Ramadan fasting is widely acknowledged for its positive impacts on health, yet it also presents inherent risks, prompting a need for comprehensive exploration into its metabolic implications and its effects on diabetes. This study introduces a novel methodology called systematic literature network analysis (SLNA), which merges bibliometric analysis with systematic literature review (SLR). The aim of this study was to examine the global research landscape concerning Ramadan fasting, metabolism, and diabetes. Through the systematic search strategy, 206 relevant documents were analyzed. Through co-occurrence analysis mapping, the study uncovered four distinct cluster groups, revealing intricate relationships and evolving trends within the field. Moreover, the trajectory of research publications on Ramadan fasting from 2001 to 2023 was tracked, highlighting a growing interest in this domain. The bibliometric analysis emphasized a consensus regarding the beneficial effects of Ramadan fasting on individual health, particularly in improving lipid profiles, managing body weight, regulating glucose levels, and nutrient intake. However, significant variations in research focus were observed across predominantly Muslim countries, with notable exceptions like Indonesia and Brunei Darussalam absent among the top contributors. Furthermore, the analysis shed light on the balanced selection of research subjects by authors, indicating a nuanced approach to exploring the multifaceted aspects of Ramadan fasting, metabolism, and diabetes. These findings offer significant perspectives for researchers aiming to contextualize their studies within the wider conversation on this subject, thereby aiding in a more profound comprehension of the intricate relationship between fasting, metabolic functions, and the management of diabetes.
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Affiliation(s)
- Baharuddin Baharuddin
- Medical Biochemistry Laboratory, Faculty of Medicine, Universitas Surabaya, Surabaya, Indonesia
- Department of Medical Science, Faculty of Medicine, Universitas Surabaya, Surabaya, Indonesia
| | - Adi Wijaya
- Department of Health Information Management, Universitas Indonesia Maju, Jakarta, Indonesia
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Ahmed WN, Arun CS, Koshy TG, Nair A, Sankar P, Rasheed SA, Ann R. Management of diabetes during fasting and COVID-19 - Challenges and solutions. J Family Med Prim Care 2020; 9:3797-3806. [PMID: 33110770 PMCID: PMC7586529 DOI: 10.4103/jfmpc.jfmpc_845_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/14/2020] [Accepted: 06/30/2020] [Indexed: 12/26/2022] Open
Abstract
Introduction: Fasting is observed as a religious custom in various forms across the globe. Among them, the Ramadan fasting is very common and widely practiced. People with diabetes observe fasting with or without obtaining medical advice. Uncontrolled diabetes appears to be a risk factor for COVID-19 infection and its poorer outcomes. Fasting during Ramadan is challenging in people with diabetes. This year, the background of COVID-19 made it difficult for both the patients and health care workers to effectively manage diabetes and its complications during Ramadan. Because of a lack of sufficient evidence, clinicians were perplexed in handling this difficult situation. Materials and Methods: We accessed PubMed, Google Scholar, various guidelines and other evidence-based articles to review the available current literature which deals with diabetes, Ramadan, and COVID-19. Results: The importance of pre-Ramadan assessment, adequate nutrition, and hydration, choosing the right therapy has been emphasized. This review tries to address the common practical challenges and relevant possible solutions for the same. Due consideration has been given to various socio-cultural practices that can influence the management of diabetes patients in the setting of Ramadan and COVID-19 pandemic. Conclusions: Diabetes is associated with increased severity and susceptibility to COVID-19. People with diabetes should go through systemic and structure-based management during fasting. Family physicians who deliver personalized care play a vital role in managing diabetes during this crisis period. Telemedicine is emerging as an effective mode of managing various needs of individuals.
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Affiliation(s)
- Waseem N Ahmed
- Department of Family and Internal Medicine, CRAFT Hospital and Research Centre, Kodungallur, Thrissur, Kerala, India
| | - Chankramath S Arun
- Department of Endocrinology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Thanuvelil G Koshy
- Department of Medicine, MOSC (Malankara Orthodox Syrian Church Medical College), Kolencherry, Ernakulam, Kerala, India
| | - Abilash Nair
- Department of Endocrinology, Govt. Medical College, Thiruvananthapuram, Kerala, India
| | - Prasanth Sankar
- Department of Internal Medicine and Diabetes, MGM Muthoot Hospitals, Pathanamthitta, Kerala, India
| | - Sabeer A Rasheed
- Dr Rasheed's Diabetic Specialty Center, Thiruvananthapuram, Kerala, India
| | - Reeja Ann
- Medical Officer, Govt Taluk Hospital, North Paravur, Ernakulam, Kerala, India
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Hanif W, Patel V, Ali SN, Karamat A, Saeed M, Hassanein M, Syed A, Chowdhury TA, Farooqi A, Khunti K. The South Asian Health Foundation (UK) guidelines for managing diabetes during Ramadan. Diabetes Res Clin Pract 2020; 164:108145. [PMID: 32335096 DOI: 10.1016/j.diabres.2020.108145] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/04/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Fasting in the holy month of Ramadan is among the five pillars of Islam and is considered as a religious obligation by the Muslim population. People with diabetes observing the practice of fasts are at a higher risk of complications such as hypoglycaemia, hyperglycaemia and ketoacidosis due to changes in eating patterns and circadian rhythms. With the objective of mitigating these complications, the South Asian Health Foundation (UK) has developed the present guidelines based on robust evidence derived from epidemiological studies and clinical trials. METHODS We have highlighted the role of pre-Ramadan risk stratification and counselling by healthcare professionals with emphasis on the need for advice on adequate dietary and fluid intake, blood glucose monitoring and awareness of when to break the fast. RESULTS We reviewed the current literature and have given clinically-relevant recommendations on lifestyle modifications and glucose-lowering therapies such as metformin, sulphonylureas, dipeptidyl peptidase-4 inhibitors, sodium glucose co-transporter-2 inhibitors, thiazolidinediones, glucagon-like peptide-1 receptor agonists and insulin. CONCLUSIONS An individualised patient-centric treatment plan is essential to not only achieve optimal glycaemic outcomes but also enable people with diabetes to observe a risk-free month of fasting during Ramadan.
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Affiliation(s)
- W Hanif
- University Hospital Birmingham. UK.
| | | | - S N Ali
- Department of Diabetes & Endocrinology, Royal Free Hospital, London, UK
| | | | - M Saeed
- University Hospital Birmingham, UK
| | - M Hassanein
- Department of Diabetes and Endocrinology, Dubai Hospital, Dubai, United Arab Emirates
| | - A Syed
- Heartlands Hospital Birmingham, UK
| | | | | | - K Khunti
- Diabetes Research Centre, University of Leicester, UK
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Ulhaque MS, Bin Zafar A, Ahmed F, Ahmedani MY. Role of 24-hour Helpline Service in the Management of Diabetes During the Holy Month of Ramadan. Cureus 2020; 12:e7320. [PMID: 32313761 PMCID: PMC7164709 DOI: 10.7759/cureus.7320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective To assess the role of the 24-hour helpline service in the management of diabetes during the holy month of Ramadan. Methodology This prospective study was conducted at the Baqai Institute of Diabetology & Endocrinology, Baqai Medical University, Karachi, Pakistan, between December 2017 and August 2018. Patients with type 1 and type 2 diabetes who were willing to observe the fast in Ramadan 2018 were included. Pre-Ramadan education on a one-to-one basis was given and the 24-hour helpline number was provided to each patient. Details of baseline characteristics, anthropometric measurements, and biochemical parameters (lipid profile, serum creatinine, urine D/R (protein), and glycated hemoglobin A1c pre- and post-Ramadan) were noted. Self-monitoring blood glucose (SMBG) recording books were provided to each patient to record blood sugar levels during Ramadan. Results A total of 102 patients, 41 (40.2%) with type 1 diabetes and 61 (59.8%) with type 2 diabetes were included. The mean age of patients with type 1 diabetes was 17.02±5.22 years and that of patients with type 2 diabetes was 49.48±9.68 years. Most of the patients were male in both groups. By using the 24-hour helpline service, 912 calls were made to patients, 502 calls for type 1, and 410 calls for type 2 diabetes. Mean HbA1c (%) level before and after Ramadan was 8.94±1.72 and 8.70±2.03 in patients with type 1 diabetes and 8.59±1.73 and 7.71±1.27 in patients with type 2 diabetes, respectively. In the last 10 days of Ramadan, the decreasing trends of mean self-monitoring of blood glucose (SMBG) in patients with type 1 diabetes was observed for pre-dawn meal (suhoor), pre-sunset meal (iftar), and before sleeping while this trend in type 2 diabetes was found in the pre-dawn meal (suhoor)and two hours after iftar. Conclusion Pre-Ramadan diabetes education and treatment adjustment by using a station-based, 24-hour helpline service during the holy month of Ramadan have a significant role in controlling blood sugar levels, thus minimizing the complications of diabetes, facilitating timely adjustments in treatment, and reducing unnecessary hospital visits and admissions.
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Affiliation(s)
- Muhammad Saif Ulhaque
- Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, PAK
| | - Awn Bin Zafar
- Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, PAK
| | - Farrukh Ahmed
- Diet and Education, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, PAK
| | - Muhammad Yakoob Ahmedani
- Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, PAK
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Hassanein M, Al Awadi FF, El Hadidy KES, Ali SS, Echtay A, Djaballah K, Dessapt-Baradez C, Khazaal FAK, Abu-Hijleh MO, Al Shaikh A, Gharbi MEH, Shehadeh N, Bennakhi A, Al Arouj M. The characteristics and pattern of care for the type 2 diabetes mellitus population in the MENA region during Ramadan: An international prospective study (DAR-MENA T2DM). Diabetes Res Clin Pract 2019; 151:275-284. [PMID: 30825560 DOI: 10.1016/j.diabres.2019.02.020] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/07/2019] [Accepted: 02/20/2019] [Indexed: 10/27/2022]
Abstract
AIMS We aimed to describe the characteristics and care of participants with diabetes during Ramadan in the Middle East and North Africa (MENA). METHODS In this prospective, observational study, we analysed the number of fasted days, number of participants fasting, glycemic control, rate of hypoglycemic events, and lifestyle patterns for participants with T2DM during Ramadan 2016. RESULTS The population included 1749 participants with T2DM. The mean (SD) duration of fasting was 27.7 (5.0) days, and 57.3% of participants fasted for the full duration of Ramadan. Following Ramadan, a significant improvement in HbA1c, FPG, and PPG was observed (p < 0.0001). Confirmed hypoglycemia increased significantly from before to during Ramadan (incidence: 4.9% vs. 10.4%, p < 0.001; adverse events: 0.11 vs. 0.22 events/month/participant, p < 0.001) and was dependent on the treatment regimen. Severe hypoglycemia incidence was 0.2% before versus 0.9% during Ramadan (p = 0.031), whereas adverse events remained comparable (0.01 events/month/participant; p = 0.154). Most participants (97.4%) reported lifestyle changes during Ramadan. CONCLUSIONS This prospective study is the first to describe the characteristics and care of participants with T2DM during Ramadan in MENA, and can be utilized in the development of evidence-based care to ensure the safety of participants who fast.
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Affiliation(s)
| | | | | | | | - Akram Echtay
- Rafic Hariri University Hospital, Beirut, Lebanon.
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