Sugar levels during Ramadan fasting
Joyce LEE (Group Leader, Pharmacy) () June 03, 20153 Jun 2015 NUS professor and her research team have shown that Ramadan fasting appeared to improve blood glucose control, especially in those whose antidiabetic medications were adjusted during Ramadan.
A first ever Ramadan study conducted in Singapore followed 153 patients before, during and after Ramadan observed improvement in blood sugar levels during fasting. The improvement was associated with dose adjustment prior to Ramadan. Changes in food intake or physical activity were not associated with the improvement. This study was conducted by Prof Joyce LEE and her team (see Image) from the Department of Pharmacy in NUS after their earlier study on a cohort of 5,172 patients from a local chronic disease database showed improving trends of blood sugar control during Ramadan. These studies also showed that the rate of hypoglycemia was minimal in those whose antidiabetic medications were adjusted. The improvement in blood sugar, however, did not sustain after Ramadan.
According to the 2014 International Diabetes Federation, 12.8% of people in Singapore are living with diabetes. Because patients with diabetes have impaired ability to regulate blood glucose effectively, fasting during Ramadan may bring about unfavorable side effects such as symptoms of hypoglycemia ranging from mild to severe. As such, patients are often advised by their clinicians not to fast. However, many devoted Muslim patients with diabetes still wish to practice fasting, hence both the clinicians and the patients need to have a good understanding on the implication of fasting in relation to the blood glucose levels during this religious month.
Based on this first-hand evidence specific to Singapore, patients should actively talk to their pharmacists or healthcare team about adjusting antidiabetic medications before embarking on fasting. By doing so, patients will be able to avoid extreme changes in their blood glucose levels, and stay safe and controlled during Ramadan. It also enables the development of a clinical algorithm that meets the needs of the religious practice specific to patients in Singapore.
Image shows a team of experts, led by Prof Joyce Lee (right) and graduate student Ms Melanie Siaw, has found that fasting during Ramadan can help to improve blood sugar levels for those with type 2 diabetes.
References
1. Siaw MY, Chew DEK, Dalan R, Abdul Shakoor SAKK, Othman N, Choo CH, Shamsuri NH, Abdual Karim SN, Chan SY, Lee JYC. “Evaluating the effect of ramadan fasting on muslim patients with diabetes in relation to use of medication and lifestyle patterns: a prospective study.” International Journal of Endocrinology. 2014 (2014) 308546.
2. Siaw MY, Chew DEK, Toh MPHS, Seah DEJ, Chua R, Tan J, Lee EYQ, Chan SY, Lee JYC. “Metabolic Parameters in Type 2 Diabetic Patients with Varying Degrees of Glycemic Control During Ramadan: An Observational Study.” Journal of Diabetes Investigation. doi: 10.1111/jdi.12374