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The Article in Brief
Efficacy and Safety of Use of the Fasting Algorithm for Singaporeans With Type 2 Diabetes (FAST) During Ramadan: A Prospective, Multicenter, Randomized Controlled Trial
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Background Most Muslims who have diabetes engage in intermittent fasting during Ramadan, yet there are concerns regarding how to safely manage diabetes while fasting. A study of fasting adults with type 2 diabetes found that those who managed their condition in collaboration with their health care provider using an empowerment-based approach, saw greater improvements in glycemic control. Health researchers from the University of California, Irvine and the National University of Singapore developed a collaborative diabetes management tool tailored for fasting Muslims and their doctors called FAST, or "Fasting Algorithm for Singaporeans with Type 2 Diabetes." The FAST tool sought to empower diabetic patients who fast with Ramadan-specific educational materials, dosing modification information for patients and their doctors, and encouragement of active self-monitoring of blood glucose before, during and after fasting.
What This Study Found The FAST tool was evaluated for safety and effectiveness in a prospective, multi-center, randomized controlled trial with 111 fasting adults with type two diabetes in Singapore. Additionally, the FAST protocol did not increase the risk of hypoglycemic events. On average, those in the FAST intervention group showed four times the reduction in hemoglobin A1c compared to the control group (-0.4% vs -0.1%, 95% CI: -0.605 to - 0.001, p = 0.049), in measures taken before and after the fasting period. There were no major hypoglycemic events in either group, and no increase in minor hypoglycemic events in the FAST group.
Implications
- The researchers conclude that the use of empowerment-based, tailored tools for diabetes management like FAST can help observant Muslims with diabetes fast safely. According to the lead author, "This is one of the first tools that brings together Ramadan education, guidance for health care providers and elements of patient empowerment, which can be incorporated into standard practice guidelines and resulting in a global paradigm shift for diabetes management among Muslims who fast during Ramadan."
Supplemental PDF: Fasting Algorithm Flow Chart
Supplemental Appendix
Files in this Data Supplement:
Author audio interview
Editor in Chief Caroline Richardson, MD chats with author Joyce Lee on religion and diabetes, and how her algorithm can support diabetic patients who fast during Ramadan.
Files in this Data Supplement:
- Audio interview with author - .mp3 file