RT Journal Article
SR Electronic
T1 Efficacy and Safety of Use of the Fasting Algorithm for Singaporeans With Type 2 Diabetes (FAST) During Ramadan: A Prospective, Multicenter, Randomized Controlled Trial
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 139
OP 147
DO 10.1370/afm.2500
VO 18
IS 2
A1 Lum, Zheng Kang
A1 Khoo, Zi Rui
A1 Toh, Wei Yann See
A1 Kamaldeen, Shaikh Abdul Kader
A1 Shakoor, Abdul
A1 Tsou, Keith Yu Kei
A1 Chew, Daniel Ek Kwang
A1 Dalan, Rinkoo
A1 Kwek, Sing Cheer
A1 Othman, Noorani
A1 Lian, Joyce Xia
A1 Bte Sunari, Raden Nurheryany
A1 Lee, Joyce Yu-Chia
YR 2020
UL http://www.annfammed.org/content/18/2/139.abstract
AB PURPOSE We aimed to evaluate the efficacy and safety of use of the Fasting Algorithm for Singaporeans with Type 2 Diabetes (FAST) during Ramadan.METHODS We performed a prospective, multicenter, randomized controlled trial. The inclusion criteria were age ≥21 years, baseline glycated hemoglobin (HbA1c) level ≤9.5%, and intention to fast for ≥10 days during Ramadan. Exclusion criteria included baseline estimated glomerular filtration rate <30 mL/min, diabetes-related hospitalization, and short-term corticosteroid therapy. Participants were randomized to intervention (use of FAST) or control (usual care without FAST) groups. Efficacy outcomes were HbA1c level and fasting blood glucose and postprandial glucose changes, and the safety outcome was incidence of major or minor hypoglycemia during the Ramadan period. Glycemic variability and diabetes distress were also investigated. Linear mixed models were constructed to assess changes.RESULTS A total of 97 participants were randomized (intervention: n = 46, control: n = 51). The HbA1c improvement during Ramadan was 4 times greater in the intervention group (−0.4%) than in the control group (−0.1%) (P = .049). The mean fasting blood glucose level decreased in the intervention group (−3.6 mg/dL) and increased in the control group (+20.9 mg/dL) (P = .034). The mean postprandial glucose level showed greater improvement in the intervention group (−16.4 mg/dL) compared to the control group (−2.3 mg/dL). There were more minor hypoglycemic events based on self-monitered blood glucose readings in the control group (intervention: 4, control: 6; P = .744). Glycemic variability was not significantly different between the 2 groups (P = .284). No between-group differences in diabetes distress were observed (P = .479).CONCLUSIONS Our findings emphasize the importance of efficacious, safe, and culturally tailored epistemic tools for diabetes management.