Oruç tutan diyabet hastalarının oruç esnasında gelişen istenmeyen olaylarına geriye dönük bakış

Year 2019, Volume: 1 Issue: 2, 20 - 22, 18.04.2019

İrfan Karahan , Aydın Çifci

https://doi.org/10.38053/agtd.483744

Cited By: 1

Abstract

Amaç: Tip
2 diyabet ülkemizde artan, ciddi bir sağlık sorunu olmaya devam etmektedir.
Günlük hayatın bir parçası olan oruç ibadetini yapmak diyabet hastaları
tarafından da talep edilmekte ve hekim görüşü istenmektedir. Bu çalışmada oruç
tutan diyabet hastalarının yaşadığı istenmeyen olay sıklığı araştırılmak
istenmiştir.  

Gereç ve yöntem: 2018
yılı ay takvimine göre Ramazan ayında oruç tutmuş ardından Kırıkkale
Üniversitesi Tıp Fakültesi İç hastalıkları polikliniğine başvuran 30 hasta
değerlendirildi. Hipoglisemi,
hipoglisemi semptomu, presenkop, senkop, dehidratasyon, hipotansiyon, ciddi
ağırlık kaybı veya kendilerinin tariflediği herhangi bir yakınma olup olmadığı
sorgulandı. Hastane veya acil servis başvuruları sorgulandı. Hastaların yaşları
ve HbA1c düzeyleri irdelendi. Ramazan öncesi hekim görüşü alıp almadıkları
soruldu.

Bulgular: Ortanca
yaş 53, ortanca HbA1c:7,3 olan 11 erkek, 19 kadın hasta değerlendirildi.
Hastaların iki tanesinde hipoglisemi, bir tanesinde kan şekeri normalken
hipoglisemi semptomu olduğu öğrenildi. Diğer istenmeyen olaylar gözlemlenmedi.
Hipoglisemi saptanan hastaların hekim görüşü almadan eski tedavilerine devam
ettikleri öğrenildi.

Sonuç: Oruç tutmak isteyen diyabet hastalarının risk
grubunun belirlenerek, hastaya uygun bireysel tedavilerin uygulanması ve yakın
takip edilmesi istenmeyen olayların yaşanmaması için yararlı olacaktır.

Keywords

Ramazan, oruç, diyabet, hipoglisemi

Retrospective view on the adverse events of diabetic patients during fasting

Abstract

Aim: Type
2 diabetes prevalence continues to increase and the disease is still healthcare
problem. Fasting, which is a part of daily life, is demanded by diabetics and
the opinion of the physician is requested. In this study, it was aimed to
investigate the frequency of adverse events experienced of diabetic patients by
fasting.

Material and Method: After
2018 Ramadan, 30 patients that were admit to Kırıkkale University Medical
Faculty Internal Diseases outpatient clinic were evaluated. Hypoglycemia,
symptoms of hypoglycemia, presyncope, syncope, dehydration, hypotension, severe
weight loss, or any symptoms they described were questioned. Hospital or
emergency room applications were questioned. Patients' ages and HbA1c levels
were examined. Before Ramadan, they were asked whether they received a doctor's
opinion.

Findings: Median
age was 53, median HbA1c was %7.3. Eleven male and 19 female patients were
evaluated. Two patients had hypoglycemia and one had hypoglycemia symptoms. No
other adverse events were observed. It was learned that the patients who had
hypoglycemia continued their old treatment without taking the physician's
opinion.

Conclusion: It
is useful to determine the risk group of diabetic patients who want to fast,
and to follow up closely about the appropriate individual therapies for
avoiding any adverse events.

Keywords

Ramadan, fasting, diabetes, hypoglycemia

References

• 1. Beshyah SA. Fasting during the month of ramadan for people with diabetes: Medicine and fiqh united at last. IJMBS; 2009;1:58–60.
• 2. Ghani F. Most Muslims say they fast during Ramadan. 2013. Available at http://www.pewresearch.org/fact-tank/2013/07/09/global-median-of-93-of-muslims-say-they-fast-during-ramadan
• 3. Al-Arouj M, Assaad-Khalil S, Buse J, et al. Recommendations for management of diabetes during Ramadan: update 2010. Diabetes Care 2010; 33: 1895-902
• 4. Ghouri N, Hussain S, Mohammed R et al. BMJ Open Diabetes Res Care. 2018 ; 6:e000520
• 5. El Toony LF, Hamad DA, Omar OM . Outcome of focused pre-Ramadan education on metabolic and glycaemic parameters in patients with type 2 diabetes mellitus. Diabetes Metab Syndr. 2018;12:761-767
• 6. Bashir M, Elhadd T, Ali H et al . A pilot study using flash continuous glucose monitoring in patients with type-2 diabetes on multiple anti-diabetic agents during Ramadan. Diabetes Metab Syndr. 2018;12:965-968
• 7. Bashier A , Khalifa AA , Abdelgadir EI et al. Safety of Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2-I) During the Month of Ramadan in Muslim Patients with Type 2 Diabetes. Oman Medical Journal. 2018; 33: 104-110
• 8. Shao Y, Lim GJ, Chua CL et al. The effect of Ramadan fasting and continuing sodium-glucose co-transporter-2 (SGLT2) nhibitör use on ketonemia, blood pressure and renal function in Muslim patients with type 2 diabetes. Diabetes Res Clin Pract. 2018; 142 :85-91
• 9. Mohan V, Kalra S, Kesavadev J. Consensus on Initiation and Intensification of Premix Insulin in Type 2 Diabetes Management. J Assoc Physicians India. 2017; 65: 59-73