Endocrine Abstracts

Background: International Diabetes Federation (IDF), in collaboration with the Diabetes and Ramadan (DAR) International Alliance proposed in 2021, IDF-DAR Practical Guidelines with a score that allows certain patients even on insulin to fast which requires regular and appropriate blood glucose monitoring.

Aim: Develop a special Ramadan blood glucose self-monitoring table in order to limit the risk of acute compilations during this month.

Method: Our work is a literature review and analysis of the pharmacokinetics of antidiabetics in order to determine the critical moments during Ramadan. It should be noted that, IFTAR: evening meal, SUHOOR: dawn meal.

Results: Our table contains 5 columns: Pre-SUHOOR, post-SUHOOR, at 1600 hours (frequent moment of hypoglycemia), Pre-IFTAR, post-IFTAR (Table 1A/ Non-insulin antidiabetics: the essential moments are: 1/ post-SUHOOR: to find out if the patient can continue fasting. 2/ at 1600 hours: the most critical period for hypoglycemia. 3/ post-IFTAR to correct dietary deviations in the event of hyperglycemia, and readjust the doses of antidiabetics in the event of hypoglycemia. B/ Basal insulin: will be readjusted according to blood glucose at 1600 hours and Pre-IFTAR. C/ short-acting insulin: the dose of IFTAR will be readjusted according to the blood glucose level post-IFTAR, the dose of SUHOOR will be readjusted according to the blood glucose post-SUHOOR. D/ Premixed insulin: the dose of IFTAR will be readjusted according to the blood glucose level post-IFTAR and Pre-SUHOOR, the dose of SUHOOR will be readjusted according to the blood glucose post-SUHOOR, at 1600 hours and Pre-IFTAR.

Conclusion: Fasting during Ramadan constitutes a major risk for diabetic patients, appropriate and regular blood glucose self-monitoring can help diabetics to manage treatment and diet well.