Title:Effect of Fasting Ramadan in Diabetes Control Status - Application of Extensive Diabetes Education, Serum Creatinine with HbA1c Statistical ANOVA and Regression Models to Prevent Hypoglycemia
Volume: 7
Issue: 3
Author(s): Kamran M.A. Aziz
Affiliation:
Keywords:
ANOVA, CRD/CKD, creatinine, diabetes, hypoglycemia, insulin, OHA, Ramadan, regression, SMBG.
Abstract: Ramadan fasting is an obligatory duty for Muslims. Unique physiologic and metabolic changes occur during
fasting which requires adjustments of diabetes medications. Although challenging, successful fasting can be accomplished
if pre-Ramadan extensive education is provided to the patients. Current research was conducted to study effective Ramadan
fasting with different OHAs/insulins without significant risk of hypoglycemia in terms of HbA1c reductions after
Ramadan. ANOVA model was used to assess HbA1c levels among different education statuses. Serum creatinine was
used to measure renal functions. Pre-Ramadan diabetes education with alteration of therapy and dosage adjustments for
OHAs/insulin was done. Regression models for HbA1c before Ramadan with FBS before sunset were also synthesized as
a tool to prevent hypoglycemia and successful Ramadan fasting in future. Out of 1046 patients, 998 patients fasted successfully
without any episodes of hypoglycemia. 48 patients (4.58%) experienced hypoglycemia. Χ2 Test for CRD/CKD
with hypoglycemia was also significant (p-value < 0.001). Significant associations and linear regression were found for
HbA1c and sunset FBS; RBS post-dawn with RBS mid-day and FBS at sunset. The proposed regression models of this
study can be used as a guide in future for Ramadan diabetes management. Some relevant patents are also outlined in this
paper.