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Fasting and Diabetes: An Experience with Safety of Fasting in Peoples with Type II Diabetes

Ahmed Bilal, Muhammad Sohail Anjum, Zaheer Ahmed.

Abstract
The objective the study is to determine the safety of fasting in patients with type II diabetes mellitus. This is a observational prospective study. A convenient sampling method is used to select the study population. All patients with well-controlled Type 2 Diabetes Mellitus treated with Insulin, sulfonylureas, lifestyle modification, metformin, or a thiazolidinedione, who are otherwise healthy were included. The study included a total 0f 30 subjects, of which 14(46.7%) were male and 16(53.3%) were female. 25(83.3%) had no hypoglycemia, 4(13.3%) had 1 episode of hypoglycemia and 1(3.3%) had 2 episodes of hypoglycemia. 24(80.0%) never needed to break a fast, 5(16.7%) had 1 event of breaking the fast and 1(3.3%) had 2 events of breaking the fast. There was 1 event of missing the fast in 2(6.7%) patients. 8 (26.7%) patients were on insulin alone, 8(26.7%) were on insulin and oral hypoglycemics combination, 4(13.4%) were on single oral hypoglycemics , 7(23.3%) were on combination oral hypoglycemic and 3(10%) were on lifestyle modification. Of 8 patients on insulin therapy, only 1 had 1 event of hyperglycemia, 1 had 2 events of hyperglycemia, 2 had 3 events of hyperglycemia and 1 had 4 events of hyperglycemia. Of 4 patients on single oral hypoglycemia, no one had any event of hyperglycemia. Of 8 patients on insulin and oral hypoglycemics combination, only 2 had 1 episode of hyperglycemia and 1 had 3 episodes of hyperglycemia. Only 1 drug related hypoglycemia in sulfonylurea group. The drug was stopped and patient switched over to metformin next day. Of 4 patients on single oral hypoglycemia, no one had any event of hyperglycemia. Of 7 patients on oral hypoglycemics combination 2 had 1 and 1 had 3 episodes of hyperglycemia. 3 patients on lifestyle modification and none had any hyperglycemia. P-Value of chi square test applied was 0.820 which is insignificant showing no relation between drug regimens and hypoglycemias. Fasting in type 2 diabetes mellitus patients is usually safe if proper cautions are observed.

Key words: Fasting, Diabetes Mellitis, hypoglycemia, hyperglycemia.



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