title: Metabolic parameters in type 2 diabetic patients with varying degrees of glycemic control during Ramadan: An observational study.
abstract: OBJECTIVE
  The changes in metabolic parameters in type 2 diabetic patients who fast during Ramadan have not been studied in Singapore. This study aimed to examine the trends of glycated hemoglobin (HbA1c), systolic blood pressure, low-density lipoprotein cholesterol, and triglycerides in diabetic patients with varying degrees of glycemic control and different types of therapeutic approaches during Ramadan.
  
  
  METHODS
  The present retrospective study used a national electronic database to examine the metabolic parameter of Malay patients with type 2 diabetes. Eligible patients were stratified into three groups based on their mean HbA1c control before Ramadan: group 1 (HbA1c ≥10%), group 2 (HbA1c 7.1-9.9%) and group 3 (HbA1c ≤7%). Patients with a glomerular filtration rate <15 mL/min were excluded. The trends of metabolic parameters were traced before, during and after Ramadan.
  
  
  RESULTS
  Of 13,565 patients examined, 5,172 patients (38.1%) were eligible for this study. Mean change of HbA1c varied from -1.4% to +0.2% during Ramadan, with the greatest reduction observed in group 1 (P < 0.001). A minimal systolic blood pressure reduction was observed in groups 2 and 3 (2 mmHg; P < 0.01). Low-density lipoprotein cholesterol and triglycerides changes were insignificant. A small, 0.1%, reduction in mean HbA1c was observed in patients taking oral antidiabetic agents during Ramadan (P < 0.001).
  
  
  CONCLUSIONS
  Blood glucose was most affected during Ramadan, particularly in patients with mean baseline HbA1c ≥10%. The type of antidiabetic agent used did not seem to contribute to glycemic changes.
authors.affiliation: Department of Pharmacy Faculty of Science National University of Singapore Singapore.
authors.forename: Melanie Y L
authors.initials: MY
authors.lastname: Siaw
authors.affiliation: Department of Endocrine and Diabetes Tan Tock Seng Hospital Singapore.
authors.forename: Daniel E K
authors.initials: DE
authors.lastname: Chew
authors.affiliation: Information Management Regional Health National Healthcare Group Singapore.
authors.forename: Matthias P H S
authors.initials: MP
authors.lastname: Toh
authors.affiliation: National Healthcare Group Polyclinics Singapore.
authors.forename: Darren E J
authors.initials: DE
authors.lastname: Seah
authors.affiliation: Department of Pharmacy Faculty of Science National University of Singapore Singapore.
authors.forename: Ruimin
authors.initials: R
authors.lastname: Chua
authors.affiliation: Department of Pharmacy Faculty of Science National University of Singapore Singapore.
authors.forename: Jielin
authors.initials: J
authors.lastname: Tan
authors.affiliation: National Healthcare Group Pharmacy Singapore.
authors.forename: Evonne Y Q
authors.initials: EY
authors.lastname: Lee
authors.affiliation: Department of Pharmacy Faculty of Science National University of Singapore Singapore.
authors.forename: Sui Yung
authors.initials: SY
authors.lastname: Chan
authors.affiliation: Department of Pharmacy Faculty of Science National University of Singapore Singapore.
authors.forename: Joyce Y C
authors.initials: JY
authors.lastname: Lee
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology*; D005215:Fasting / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D038321:Glycemic Index / Q000502:physiology; D006801:Humans; D007514:Islam; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012846:Singapore / Q000208:ethnology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Metabolic parameters; Ramadan; Type 2 diabetes
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