Self-Monitoring of Blood Glucose and Hypoglycemia Association During Fasting in Ramadan Among Patients with Diabetes

Deyaa Mansouri; Ebtehal Khayat; Mohannad Khayat; Muteb Aboawja; Areej Aseeri; Faisal Banah; Khulood Alsiary; Lama Abdulaziz Rammal; Adel D Almalki; Mohammed Hasaballah

doi:10.2147/DMSO.S234675

Self-Monitoring of Blood Glucose and Hypoglycemia Association During Fasting in Ramadan Among Patients with Diabetes

Diabetes Metab Syndr Obes. 2020 Apr 5:13:1035-1041. doi: 10.2147/DMSO.S234675. eCollection 2020.

Authors

Affiliations

¹ Hera General Hospital, Mecca, Saudi Arabia.
² Joint Program of Family Medicine, Mecca, Saudi Arabia.
³ Joint Program of Community Medicine, Mecca, Saudi Arabia.
⁴ King Faisal Medical City, Abha, Saudi Arabia.
⁵ King Fahad Military Medical Complex, Dhahran, Saudi Arabia.
⁶ Armed Hospital Southen Rigon, KhamisMushait, Saudi Arabia.
⁷ King Abdulaziz Medical City, Jeddah, Saudi Arabia.
⁸ King Salman Bin Abdulaziz Hospital, Riyadh, Saudi Arabia.
⁹ King Faisal Hospital, Mecca, Saudi Arabia.

Abstract

Purpose: The study aims to assess current practices of patients with diabetes to control blood glucose levels during Ramadan.

Patients and methods: A cross-sectional approach has been used for collecting data through a structured and interview-based questionnaire to assess the association between self-monitoring of blood glucose (SMBG) and hypoglycemia. The questionnaire has recorded information about demographics, duration of diabetes, and treatment of diabetes, and hypoglycemia complications faced during Ramadan. The primary outcomes of this study include frequency of SMBG during fasting in Ramadan and association of SMBG and hypoglycemia and break of fasting. However, the secondary outcomes include medications, glycemic control, and other influencing factors. The data was analyzed using Statistical Package of Social Sciences (SPSS) version 20.

Results: The findings have shown that the majority of the patients used a combination of metformin+sulphonylurea (23.02%) following metformin+insulin (20.86%), insulin (12.94%), and metformin (8.63%). Whereas diet control, high or low blood sugar, insulin dose adjustment in fasting conditions were the most influential factors during Ramadan when the blood sugar levels were tested. Majority of the patients monitored their blood glucose level during pre-iftar (56.8%) following to hypoglycemia (30.2%), post-iftar (29.4%), and rarely monitored in afternoon (3.5%) despite that only 10.1% monitored their blood glucose on a daily basis. Patients who had symptoms of hypoglycemia and had to break their fasting at least once were 41% and 27.2%, respectively. There is a significant association between age and gender with symptoms of low blood sugar level. Additionally, a significant association between blood sugar monitoring and high blood sugar level has been shown (p=0.041), indicating that lack in daily blood sugar monitoring can increase the blood sugar level of a patient during Ramadan.

Conclusion: The present study has helped in providing better understanding about the self-monitoring of blood glucose level and hypoglycemia. Furthermore, it also emphasizes the pre-Ramadan education about when to break their fasting along with frequency and timing of SMBG.

Keywords: glycemic control; insulin; medication; metformin; sulphonylurea.