ARTICLE INFO

Article Type

Original Research

Authors

Bagheri   P. (1)
Delshad Noghabi   A. (2)
Moshki   M. (*)






(*) “Social Development & Health Promotion Research Center” & “Public Health Department, Health Faculty” , Gonabad University of Medical Science , Gonabad, Iran
(1) Department of Social Medicine, Faculty of Hygiene , Jiroft University of Medical Sciences, Jiroft, Iran
(2) Social Development & Health Promotion Research Center , Gonabad University of Medical Science, Gonabad, Iran

Correspondence

Address: Development & Health Promotion Research Center, Gonabad University of Medical Science, Near Asian Road, Gonabad, Khorasan Razavi, Iran. Post Box: 397
Phone: +985337259025
Fax: +985337259025
drmoshki@gmail.com

Article History

Received:  June  6, 2013
Accepted:  March 2, 2014
ePublished:  February 1, 2014

BRIEF TEXT


Probability of severe hyperglycemia in patients with type II diabetes increases with changes in dietary patterns during Ramadan [4]. During this month, blood biochemical factors and urine, especially blood sugar, may be affected by changes in level and kind of received energy and sleeping habits, as well as changes in daily bodily activities.

There are many researches, which show hypoglycemia during fasting in Ramadan [5]. Nevertheless, some other studies show that, concerning biochemical parameters, fasting does not result in any disturbance and instead, it provides healthier persons [6, 7]. A conducted research shows no change in diastolic blood pressure and some biochemical parameters such as urine; however, it shows decrease in weight and BMI [8]. Another conducted study has been concerned average fasting blood sugar, cholesterol, and triglyceride of fasting pregnant women [9].

The aim of the present study was to investigate changes in body weight, blood pressure, and biochemical parameters’ concentration in fasting people, in order to help them in decision making about fasting.

The study is descriptive cross-sectional.

Research society was the population of diabetic patients from Kenareh village, Marvdast Township, Fars province, Iran. The study was conducted during July 2012 (Ramadan).

At first, 75 patients with type II diabetes, who were under coverage of rural health centers, were entered into the study. Sample size was estimated 60 persons, considering alpha and beta error 0.05 and 0.2 respectively and based on a study conducted by Sharifi et. al. [28], as well as considering biochemical parameters’ changes before and after Ramadan. Patients, who were not fasting or were fasting but not regularly, were excluded from the study. In addition, the onset of menstruation in women during fasting was considered the most important exclusion criterion for them. Finally, results from 60 patients were entered into the final computation and 15 persons were excluded from the study for various reasons.

15 days before Ramadan, triglyceride (using enzymatic method; RAXT, China), fasting blood sugar (using enzymatic method with glucose oxidase kit; RAXT, China), systolic and diastolic blood pressure in the sitting position, weight, height, BMI, and age of the samples were computed and recorded. Before Ramadan, all the samples were investigated concerning disease severity based on WHO classification [2]. All the samples were of persons with moderate risk category (i. e. patients under proper control, who are being treated with rapid-acting insulin secretion stimulus, sulfonylurea, insulin, some oral medications, or oral medications with insulin). At final stage, 7 days after Ramadan, all the samples referred to the center and the parameters investigated before Ramadan were computed and recorded again. At this stage, concerning any probable side effect of fasting such as hypoglycemia, hyperglycemia, and diabetic ketoacidosis (DKA), all the samples were investigated using test strip method (SIGMA, China). Statistical significance of the studied parameters before and after Ramadan was performed by the use of Paired T test in the format of Minitab 15 software. Pearson Correlation test and Two Sample T test were used to compare the relation of each parameter with age and with sex, respectively.

31 samples (51.7%) were female. Mean age of the samples was63.86±13.17years (minimum 38 and maximum 87). 49 persons (81.7%) were using hypoglycemic oral medications; and 28 persons (46.7%) were using blood pressure-lowering drugs. In addition, 22 persons (36.7%) were using insulin. During Ramadan, the samples’ weight, systolic blood pressure, triglyceride concentration, blood sugar concentration, and BMI decreased significantly. However, diastolic blood pressure did not show significant decrease. There was a significant statistical relation between all the parameters and sex variable. Average decreases in weight, blood sugar, and BMI parameters in women were more than those of men did; and average decreases in systolic blood pressure and triglyceride parameters in men were more than those of women did. There was no significant relation between age and the parameters before and after Ramadan. During Ramadan, none of the patients had probable side effects and hypoglycemia. After Ramadan, 4.9% of the samples were infected with hypoglycemia, 23.8% of the samples were infected with hyperglycemia, and 1.9% of the samples were infected with DKA. Persons, who had consumed insulin before and during Ramadan, were less infected with hypoglycemia.

Results of the present study, concerning rate of side effects among fasting diabetic patients and showing less infection of side effects such as DKA and hyperglycemia among persons who consumed insulin during Ramadan, were not found among the results of other studies. According to the results of the present study, there were no probable side effects and hypoglycemia during Ramadan and while fasting. These results are consistent with the results of a conducted study by Larijani et. al. [3]. Some researches show weight-loss more than and less than that of the present study do, without BMI change [14, 15], and some others indicates fasting an effective heal for obesity and overweight [10-13]. Results of the present study show that during Ramadan weight-loss among women was more than that of men do, which is a result consistent with the results of a conducted study by Bu Hallal et. al., while this is inconsistent with those of Hamadi [17, 18]. A study conducted in Tehran city shows a slight decrease in the blood glucose at first days of Ramadan and increase in it up to the level of the first day of fasting, as well as reaching to the level of days before Ramadan [12]. These results are inconsistent with those of the present study. Results of the present study are fully consistent with the results of a conducted study by Rahbar et. al. concerning decrease in biochemical parameters resulted by fasting; and they are moderately consistent with results of a conducted study by Navaei et. al, noticing no decrease in blood sugar according to this last mentioned study [8, 9].

It is suggested that in future studies patients’ dawn and night dietary patterns and their body activity patterns to be studied, alongside comparison between urban and rural populations.

The only limitation for the study, which was the most important one, was different operating time of some studies. However, they were not entered in analyzing process.

All the changes in biochemical parameters in serum among type II diabetic patients caused by fasting result in decrease in risk factors of diabetes, serum concentration of blood sugar, triglyceride, BMI, and weight.

Researchers feel grateful to personnel of health centers at Marvdasht Township and the patients who participated in the study.

Non-declared

Competent authorities gave ethical permission.

Non-declared

TABLES and CHARTS

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