Diabetes Management during Ramadan

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Questions and Answers

What is a crucial aspect of pre-fasting assessment in individuals with diabetes?

Restriction of carbohydrate intake

Adjustment of insulin doses

Evaluation of hypoglycemia awareness (correct)

Implementation of real-time CGM

What is recommended for individuals with diabetes wishing to fast during Ramadan?

To implement real-time CGM during fasting

To adjust insulin doses based on SMBG readings

To receive pre-Ramadan assessment and education (correct)

To fast for a few days during the 2 months preceding Ramadan

What is the primary goal of optimizing glycemia before fasting?

To stimulate glycogenolysis

To reduce the potential risks associated with fasting (correct)

To promote ketogenesis

To increase insulin secretion

What is the most common time when hypoglycemia is typically encountered during Ramadan?

During the hours preceding Iftar Signup and view all the answers

What is the purpose of frequent SMBG or real-time CGM during fasting?

To monitor glucose levels and take actions to prevent complications Signup and view all the answers

What is the primary reason for monitoring blood glucose levels during fasting hours?

To predict, prevent, and treat hypoglycemia Signup and view all the answers

What is the recommended response to hypoglycemia during fasting?

To immediately breakfast to treat hypoglycemia Signup and view all the answers

What is the primary source of glucose during the early hours of fasting in healthy individuals?

Glycogenolysis Signup and view all the answers

What is the recommended action if symptoms suggestive of hypoglycemia are experienced during fasting?

Check blood glucose levels and interrupt the fast if necessary Signup and view all the answers

What is the primary consequence of fasting on glucose metabolism in people with diabetes?

Accelerated lipolysis and ketosis Signup and view all the answers

What is the recommended method for detecting euglycemic ketosis during fasting?

Blood glucose and ketone values Signup and view all the answers

What is a priority during sick days in people with diabetes?

Preventing dehydration Signup and view all the answers

What is the purpose of carbohydrate counting during Ramadan?

To match the rapid-acting insulin dose to the carbohydrate intake Signup and view all the answers

What is the primary concern for people with T2D during Ramadan?

Hypoglycemia Signup and view all the answers

What is included in the management plan during Ramadan according to the ADA/EASD consensus?

Identification of the individual's risk category and other risk factors Signup and view all the answers

How frequently should blood glucose levels be monitored during Ramadan in high-risk groups?

Regularly and more frequently during fasting Signup and view all the answers

What is the primary goal of diabetes education during Ramadan?

Preventing acute complications Signup and view all the answers

Why is CGM not routinely recommended for individuals with T2D during Ramadan?

It is not currently recommended for individuals with T2D Signup and view all the answers

Study Notes

Pre-Fasting Assessment and Education

Medical assessment including evaluation of hypoglycemia awareness is essential before fasting.
Optimization of glycemia before fasting reduces potential risks associated with fasting and minimizes glucose fluctuations.
Frequent SMBG or real-time CGM/isCGM, along with training on how to interpret readings and actions to take, is necessary.

Physiology of Fasting

In healthy individuals, circulating BGLs tend to fall during fasting, leading to decreased insulin secretion.
Levels of glucagon and catecholamines rise, stimulating glycogenolysis and gluconeogenesis.
Glycogenolysis meets glucose requirements in the early hours of fasting, followed by gluconeogenesis and later ketogenesis.

Management of Fasting for People with T2D

Management aims to achieve control of symptoms, reasonable glycemic targets, and prevention of acute complications like hypoglycemia.
Identification of individual risk category and other risk factors, such as sub-optimal adherence to medications, is crucial.
Regular and more frequent monitoring of BGLs during fasting, especially for those on insulin, insulin secretagogues, and high-risk groups, is necessary.

Acute Complications

Hypoglycemia is a common concern for people with T2D, especially during the hours preceding Iftar.
Fasting increases glucagon levels and accelerates lipolysis and ketosis, leading to metabolic decompensation in people with diabetes.
Detection of euglycemic ketosis during fasting requires acid-base evaluation, blood glucose, and ketone values to differentiate DKA from ketosis due to prolonged fasting.

Prevention of Dehydration

Prevention of dehydration should be a priority during sick days.

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Description

Test your knowledge on managing Type 1 Diabetes during Ramadan fasting. Learn how to monitor blood glucose levels and prevent hypoglycemia and hyperglycemia. Essential for young adults with suboptimal diabetes management.