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SAT164 Hypoglycemia Risk And Glucose Parameters In Pregnant Women With Or Without Diabetes During Fasting Ramadan
Disclosure: R.M. Alamoudi: None. A. Theyab: None. T. Shams: None. H. Alhashemi: None. Background: Pregnancy increases the risk of fasting hypoglycemia and is considered an exemption for fasting during Ramadan. Glucose patterns and hypoglycemia risk in relation to fasting Ramadan in pregnant women ar...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10554447/ http://dx.doi.org/10.1210/jendso/bvad114.1028 |
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author | Alamoudi, Reem Mohammad Theyab, Abeer Shams, Taghreed Alhashemi, Hashem |
author_facet | Alamoudi, Reem Mohammad Theyab, Abeer Shams, Taghreed Alhashemi, Hashem |
author_sort | Alamoudi, Reem Mohammad |
collection | PubMed |
description | Disclosure: R.M. Alamoudi: None. A. Theyab: None. T. Shams: None. H. Alhashemi: None. Background: Pregnancy increases the risk of fasting hypoglycemia and is considered an exemption for fasting during Ramadan. Glucose patterns and hypoglycemia risk in relation to fasting Ramadan in pregnant women are not well studied. Objectives: To compare the risk of hypoglycemia, glucose patterns, and tolerance of fasting in pregnant women with gestational diabetes (GDM) versus women without GDM during fasting Ramadan. Methods: A prospective observational study conducted in the Obstetrics/Endocrine clinics at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Pregnant women without GDM, and with GDM managed by diet or metformin, who were planning on fasting Ramadan and were dedicated to applying a flash glucose monitoring (CGM) device for two weeks were recruited. Women with GDM received standard-of-care diabetes education regarding fasting during Ramadan. Participation was entirely voluntary. Results: 30 women with gestational age ≥ 24 weeks completed the study; 8 without GDM (Gp. 1), 16 with GDM on diet (Gp. 2), and 6 with GDM on metformin (Gp. 3). Mean demographics respectively: Age 30.13 ±4.9 vs. 33.56 ±6.4 vs. 34.50 ±5.8 (p=0.2), BMI 34.36 ±5.88 vs. 30.74 ±3.75 vs. 36.75 ±8.01 (p=0.4), Gravida 3 ±2.2 vs. 3.38 ± 2.48 vs. 4.33 ±2.88 (p=0.6). Breaking Ramadan fasting was reported in 13 (43%) of all participants; 3 (37.5%) vs. 6 (37.5%) vs. 4 (66.7%), respectively. The median (IQR) days fast broken were 2 vs 2 (4) vs 1 (11) days, p=0.2, with the reason being hypoglycemia in 1 vs 4 vs 2, and hyperglycemia in 0 vs 1 vs 2, the other reasons included fatigue and acute illness, p=0.3. The average hypoglycemia glucose reading in mg/dl (M± S.D) associated with breaking the fast was 56 ±4.8, p=0.54. The usual timing of hypoglycemia was late evening, while for hyperglycemia it was post-midnight meal followed by post-Suhoor (predawn meal). Ambulatory glucose profile (AGP) parameters per 450 patient days for the three groups respectively: Average glucose (mg/dl) (median - IQR) 89 (13) vs. 95 (24) vs. 103 (34), p=0.3, Time spent within range (BG 63-140 mg/dl) 87 (6)% vs. 81 (16)% vs. 80 (44) %, p=0.1, Glucose management indicator (M ±S.D) 5.4 ±0.2%, 5.6 ±0.4%, 5.5 ±0.3%, p=0.5, and Glucose variability 17.6 ±1.9%, 20.8 ±2.9%, 24.7 ±11.5%, p=0.07. Time spent above range (BG >140 mg/dl) 7 ±6% vs. 18 ±19% vs. 25 ±26%, p=0.2, Time spent below range (BG <63 mg/dl) 8 ±8% vs. 7 ±8% vs. 10 ±21%, p=0.8, and Duration spent in hypoglycemia (minutes) 90 ±117.4, 65.8 ±61.1, 70 ±108.03, p=0.8. CGM-detected hypoglycemic events (BG <63 mg/dl) were found in 20 (66.7%) of all participants, the average number of events (median-IQR) per group was: 4 (5) vs. 6 (8) vs. 1 (15), p=0.8. Conclusion: Pregnant women with non-insulin-treated GDM compared to those without GDM experienced similar difficulties in tolerating fasting during Ramadan and increased risk of hypoglycemia. The potential perinatal harm needs more research. ClinicalTrials.gov NCT04862390 Presentation: Saturday, June 17, 2023 |
format | Online Article Text |
id | pubmed-10554447 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-105544472023-10-06 SAT164 Hypoglycemia Risk And Glucose Parameters In Pregnant Women With Or Without Diabetes During Fasting Ramadan Alamoudi, Reem Mohammad Theyab, Abeer Shams, Taghreed Alhashemi, Hashem J Endocr Soc Diabetes And Glucose Metabolism Disclosure: R.M. Alamoudi: None. A. Theyab: None. T. Shams: None. H. Alhashemi: None. Background: Pregnancy increases the risk of fasting hypoglycemia and is considered an exemption for fasting during Ramadan. Glucose patterns and hypoglycemia risk in relation to fasting Ramadan in pregnant women are not well studied. Objectives: To compare the risk of hypoglycemia, glucose patterns, and tolerance of fasting in pregnant women with gestational diabetes (GDM) versus women without GDM during fasting Ramadan. Methods: A prospective observational study conducted in the Obstetrics/Endocrine clinics at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Pregnant women without GDM, and with GDM managed by diet or metformin, who were planning on fasting Ramadan and were dedicated to applying a flash glucose monitoring (CGM) device for two weeks were recruited. Women with GDM received standard-of-care diabetes education regarding fasting during Ramadan. Participation was entirely voluntary. Results: 30 women with gestational age ≥ 24 weeks completed the study; 8 without GDM (Gp. 1), 16 with GDM on diet (Gp. 2), and 6 with GDM on metformin (Gp. 3). Mean demographics respectively: Age 30.13 ±4.9 vs. 33.56 ±6.4 vs. 34.50 ±5.8 (p=0.2), BMI 34.36 ±5.88 vs. 30.74 ±3.75 vs. 36.75 ±8.01 (p=0.4), Gravida 3 ±2.2 vs. 3.38 ± 2.48 vs. 4.33 ±2.88 (p=0.6). Breaking Ramadan fasting was reported in 13 (43%) of all participants; 3 (37.5%) vs. 6 (37.5%) vs. 4 (66.7%), respectively. The median (IQR) days fast broken were 2 vs 2 (4) vs 1 (11) days, p=0.2, with the reason being hypoglycemia in 1 vs 4 vs 2, and hyperglycemia in 0 vs 1 vs 2, the other reasons included fatigue and acute illness, p=0.3. The average hypoglycemia glucose reading in mg/dl (M± S.D) associated with breaking the fast was 56 ±4.8, p=0.54. The usual timing of hypoglycemia was late evening, while for hyperglycemia it was post-midnight meal followed by post-Suhoor (predawn meal). Ambulatory glucose profile (AGP) parameters per 450 patient days for the three groups respectively: Average glucose (mg/dl) (median - IQR) 89 (13) vs. 95 (24) vs. 103 (34), p=0.3, Time spent within range (BG 63-140 mg/dl) 87 (6)% vs. 81 (16)% vs. 80 (44) %, p=0.1, Glucose management indicator (M ±S.D) 5.4 ±0.2%, 5.6 ±0.4%, 5.5 ±0.3%, p=0.5, and Glucose variability 17.6 ±1.9%, 20.8 ±2.9%, 24.7 ±11.5%, p=0.07. Time spent above range (BG >140 mg/dl) 7 ±6% vs. 18 ±19% vs. 25 ±26%, p=0.2, Time spent below range (BG <63 mg/dl) 8 ±8% vs. 7 ±8% vs. 10 ±21%, p=0.8, and Duration spent in hypoglycemia (minutes) 90 ±117.4, 65.8 ±61.1, 70 ±108.03, p=0.8. CGM-detected hypoglycemic events (BG <63 mg/dl) were found in 20 (66.7%) of all participants, the average number of events (median-IQR) per group was: 4 (5) vs. 6 (8) vs. 1 (15), p=0.8. Conclusion: Pregnant women with non-insulin-treated GDM compared to those without GDM experienced similar difficulties in tolerating fasting during Ramadan and increased risk of hypoglycemia. The potential perinatal harm needs more research. ClinicalTrials.gov NCT04862390 Presentation: Saturday, June 17, 2023 Oxford University Press 2023-10-05 /pmc/articles/PMC10554447/ http://dx.doi.org/10.1210/jendso/bvad114.1028 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Diabetes And Glucose Metabolism Alamoudi, Reem Mohammad Theyab, Abeer Shams, Taghreed Alhashemi, Hashem SAT164 Hypoglycemia Risk And Glucose Parameters In Pregnant Women With Or Without Diabetes During Fasting Ramadan |
title | SAT164 Hypoglycemia Risk And Glucose Parameters In Pregnant Women With Or Without Diabetes During Fasting Ramadan |
title_full | SAT164 Hypoglycemia Risk And Glucose Parameters In Pregnant Women With Or Without Diabetes During Fasting Ramadan |
title_fullStr | SAT164 Hypoglycemia Risk And Glucose Parameters In Pregnant Women With Or Without Diabetes During Fasting Ramadan |
title_full_unstemmed | SAT164 Hypoglycemia Risk And Glucose Parameters In Pregnant Women With Or Without Diabetes During Fasting Ramadan |
title_short | SAT164 Hypoglycemia Risk And Glucose Parameters In Pregnant Women With Or Without Diabetes During Fasting Ramadan |
title_sort | sat164 hypoglycemia risk and glucose parameters in pregnant women with or without diabetes during fasting ramadan |
topic | Diabetes And Glucose Metabolism |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10554447/ http://dx.doi.org/10.1210/jendso/bvad114.1028 |
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