title: Glycemic Control among Pregnant Diabetic Women on Insulin Who Fasted During Ramadan.
abstract: BACKGROUND
  Ramadan fasting for pregnant women with diabetes remains controversial and underreported. The objective of this study was to determine the glycemic control in pregnant diabetic women on insulin who fasted during Ramadan.
  
  
  METHODS
  This was a retrospective study carried out over a period of three years including pregnant diabetic women, who were on short-acting, intermediate-acting, or a combination of them, and opted to carry out Ramadan fasting. Glycemic control was assessed before, middle and after Ramadan fasting.
  
  
  RESULTS
  Thirty seven women opted to fast with 24 (64.9%) of them had type 2 diabetes mellitus and 83.8% of them required combined insulin (short- acting, intermediate-acting) therapy. The age of the participants was 32.13±4.68 years, and the age of their pregnancies was 25.60±7.12 weeks when the study was performed. The median number of days fasted was 25 days, and most of the women were able to fast for more than 15 days. There was no difference between glycemic control of type 2 diabetes mellitus and gestational diabetes mellitus women prior to fasting. In the middle of Ramadan, serum fructosamine decreased in both groups. However, only serum HbA1c reduced in gestational diabetes mellitus after Ramadan.
  
  
  CONCLUSIONS
  the findings indicate that pregnant diabetic women on insulin were able to fast during Ramadan and that their glycemic control was improved during fasting period. They may also suggest that instead of absolute ban on fasting for pregnant diabetic women more practical approach and close consultation with health care providers might be more helpful.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Nor Azlin Mohamed
authors.initials: NA
authors.lastname: Ismail
authors.forename: Hadijat
authors.initials: H
authors.lastname: Olaide Raji
authors.forename: Norashikin
authors.initials: N
authors.lastname: Abd Wahab
authors.forename: Norlaila
authors.initials: N
authors.lastname: Mustafa
authors.forename: Nor Azmi
authors.initials: NA
authors.lastname: Kamaruddin
authors.forename: Muhammad
authors.initials: M
authors.lastname: Abdul Jamil
keywords: Fasting; diabetes; gestational diabetes; insulin; pregnancy