EXPERIENCES WITH DIFFERENT TYPES OF INSULIN FOR PEOPLE WITH DIABETES WHO FAST RAMADAN

Yıl 2025, Cilt: 1 Sayı: 3, 103 - 108, 29.11.2025

Mehmet Akif Büyükbeşe

https://doi.org/10.65308/gjohbs.2025.015

https://izlik.org/JA67WD73PM

Öz

Dramatic number of muslim people with diabetes mellitus (DM) fast Ramadan all around the world, although because of sickness they are exempt from observing the fast. All type 1 diabetes (most aged less than 18 years) and considerable number of people with type 2 diabetes (mostly adult population) -besides pills (tablets)- will eventually need insulin injection therapy during the course of their disease. Despite many developments in the management of DM, hypoglycaemia (low blood glucose) is an ongoing concern and mostly seen with insulins among the other class of drugs being used in the management of both types of diabetes, today. International Diabetes Federation Diabetes and Ramadan Alliance Group (IDF-DaR) published 2 recommendations determining the risk scores for those who insist on fasting. Not all insulins are the same; with analogues safe fasting was demonstrated by multi-country, multi-center collaborative studies. Especially in the northern hemisphere of the earth, during long summer days of holy month Ramadan (more than 16 hrs-fasting) may increase the risk of hypoglycaemia (hypo) for many.

Anahtar Kelimeler

Diabetes Mellitus (DM) , Ramadan , Fasting , Glucose , Hypoglycaemia (Hypo) , Insulin

Etik Beyan

N/A

Destekleyen Kurum

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Proje Numarası

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Teşekkür

I'd like to thank to Professor Mohamed Hassanein, MD who is the president of International Diabetes Federation, Diabetes and Ramadan Alliance Group (IDF-DaR) and faculty member at endocrinology department of both Cardiff (UK) and Gulf (UAE) Universities who provided international collaboration and workshop for healthcare professionals and people with diabetes who fast Ramadan.

RAMAZANDA ORUÇ TUTAN DİYABETLİLERDE FARKLI İNSÜLİN TİPLERİNİN KULLANIMI İLE İLGİLİ DENEYİMLER

https://izlik.org/JA67WD73PM

Öz

-Her ne kadar hastalıktan dolayı tutmayabilecekleri halde-, dünyanın pek çok yerinde bu gün çok sayıda diyabetli müslüman Ramazan orucu tutmaktadır. Tip 1 diyabetlilerin tamamı (çoğunluğu 18 yaşın altında) ve tip 2 diyabetlilerin de (çoğunlukla erişkinde görülen diyabet) hatırı sayılı miktarı -ağızdan kullanılan hapların (tabletlerin) yanı sıra-, hastalığın gidişatı sırasında insülin enjeksiyon tedavisine ihtiyaç gösterirler. Diabetes mellitus (DM) tedavisindeki çok sayıda gelişmeye rağmen, hipoglisemi (hipo) (kan glikozunda düşme), bu gün kullanılan ilaçlar arasında, her iki diyabet tedavisinde de yer edinen insülinler ile çoğunlukla görülmekte ve bir kaygı nedeni olmayı sürdürmektedir. Oruç tutmak isteyenler için risk skorlarını belirlemek amacıyla Uluslararası Diyabet Federasyonu Diyabet ve Ramazan Çalışma Grubu tarafından (IDF-DaR) kılavuzlar yayınlanmıştır. Tüm insülinler aynı değildir; çok sayıda ülke ve merkezi içeren çalışmalarda insülin analogları ile güvenli bir şekilde oruç tutulabildiği gösterilmiştir. Özellikle dünyamızın kuzey yarımküresinde, uzun yaz günlerine denk gelen Ramazan ayında oruç süreleri 16 saatin üzerine çıkarak, çoğu kimse için hipoglisemi riskini arttırabilmektedir.

Anahtar Kelimeler

Diabetes Mellitus (DM) , Ramazan , Oruç , Glikoz , Hipoglisemi (Hipo) , İnsülin

Etik Beyan

N/A

Destekleyen Kurum

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Proje Numarası

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Teşekkür

IDF-DaR başkanı ve İngiltere Cardiff ve Birleşik Arab Emirlikleri Gulf Üniversiteleri Endokrinolojide öğretim üyesi olan Prof Mohamed Hassanein'e, Ramazanda oruç tutan hastalar ve onlarla ilgilenen sağlık çalışanları için yapmış olduğu uluslararası işbirliği çalışmalarından ötürü teşekkür ederim.

Kaynakça

• 1. Jacobs PG, Levy CJ, Brown SA, Riddell MC, Cinar A, Boughton CK, et al. Research Gaps, Challenges, and Opportunities in Automated Insulin Delivery Systems. Diabetes Technol Ther. 2025;27(S3):S60-S71.
• 2. Thaware PK, Buyukbese MA, Skinner TC, Tringham JR, Jarvis J, Davies MJ. Attitudes of healthcare professionals regarding initiation of insulin therapy in patients with type 2 diabetes mellitus-a questionnaire based study in Leicester, UK and Kahramanmaras, Turkey. Diyabet Forum 2006;3(4), 41-48. (Turkish published)
• 3. https://idf.org/media/uploads/2025/04/IDF_Rec_2025.pdf. (Access date:26.07.2025)
• 4. https://pro.aace.com/clinical-guidance/diabetes. (Accessdate:26.07.2025)
• 5. https://diabetesjournals.org/care/article/48/Supplement_1/S27/157566/2-Diagnosis-and-Classification-of-Diabetes.(Access date:26.07.2025)
• 6. Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care 2002;25(9):1551-6.
• 7. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28(2):169-80.
• 8. Satman I, Bayirlioglu S, Okumus F, Erturk N, Yemenici M, Cinemre S, et al. Estimates and Forecasts on the Burden of Prediabetes and Diabetes in Adult and Elderly Population in Turkiye. Eur J Epidemiol. 2023;38(3):313-323.
• 9. Ozcan S, Buyukbese MA. Southeastern Anatolia Diabetes Project. FEND (Federation of European Nurses in Diabetes) 9th Annual Conference Munich, GERMANY September 3-4, 2004 (Oral presentation-2nd Prize).
• 10. https://www.turkdiab.org/admin/PICS/webfiles/00_DIYABET_YASAM_SAYI_42.pdf. Sf.65. (Access date:26.07.2025) (Turkish published)
• 11. https://diabetesatlas.org/resources/idf-diabetes-atlas-2025/. (Access date:13.07.2025).
• 12. Hanif S, Ali SN, Hassanein M, Khunti K, Hanif W. Managing People with Diabetes Fasting for Ramadan During the COVID-19 Pandemic: A South Asian Health Foundation Update. Diabet Med. 2020; 37:1094-102.
• 13. Surah Al-Baqarah, 2:185. https://quran.com/al-baqarah/185. (Access date:26.07.2025)
• 14. Salti I, Bénard E, Detournay B, Bianchi-Biscay M, Le Brigand C, Voinet Cl, et al. A Population-Based Study of Diabetes and Its Characteristics During the Fasting Month of Ramadan in 13 Countries: Results of the Epidemiology of Diabetes and Ramadan 1422/2001 (EPIDIAR) study. Diabetes Care 2004;27(10):2306-11.
• 15. Babineaux SM, Toaima D, Boye KS, Zagar A, Tahbaz A, Jabbar A, et al. Multi-country retrospective observational study of the management and outcomes of patients with Type 2 diabetes during Ramadan in 2010 (CREED). Diabet Med. 2015;32:819–28.
• 16. Hassanein M, Alamoudi RM, Kallash MA, Aljohani NJ, Alfadhli EM, Tony LE, et al. Ramadan fasting in people with type 1 diabetes during COVID-19 pandemic: The DaR Global survey. Diabetes Res Clin Pract. 2021;172:108626.
• 17. Hassanein M, Hussein Z, Shaltout I, Wan Seman WJ, Tong CV, Mohd Noor N, et al. The DAR 2020 Global survey: Ramadan fasting during COVID 19 pandemic and the impact of older age on fasting among adults with Type 2 diabetes. Diabetes Res Clin Pract. 2021;173:108674.
• 18. Hassanein M, Al-Arouj M, Hamdy O, Bebakar WMW, Jabbar A, Al-Madani A, et al. Diabetes and Ramadan: Practical guidelines. Diabetes Res Clin Pract. 2017;126:303-16.
• 19. Hassanein M, Afandi B, Ahmedani MY, Alamoudi RM, Alawadi F, Bajaj HS , et al. Diabetes and Ramadan: Practical guidelines 2021. Diabetes Res Clin Pract. Diabetes Res Clin Pract. 2022;109185.
• 20. Bravis V, Hui E, Salih S, Mehar S, Hassanein M, Devendra D. Ramadan Education and Awareness in Diabetes (READ) programme for Muslims with Type 2 diabetes who fast during Ramadan. Diabet Med. 2010;27(3):327-31.
• 21. https://daralliance.me/#aboutus (Access date:13.07.2025).
• 22. Hassanein M , Zainudin SB , Shaikh S ,Shaltout I ,Malek R, Buyukbese MA, et al. An update on the current characteristics and status of care for Muslims with type 2 diabetes fasting during Ramadan: the DAR global survey 2022. Curr Med Res Opin. 2024;40(9):1515-23.
• 23. Hassanein M, Ahmedani MY, Shaltout I, Alabbood M, Buyukbese MA, Hafidh K, et al. Ramadan fasting among adults with type 2 diabetes in five geographically different regions of the world: The DAR 2020 global survey. Diabetes Epidemiology and Management 2024; 16:100229. doi.org/10.1016/j.deman.2024.100229.
• 24. Hassanein M, Buyukbese MA, Malek R, Pilorget V, Naqvi M, Berthou B, et al. Real-world safety and effectiveness of insulin glargine 300 U/mL in participants with type 2 diabetes who fast during Ramadan: The observational ORION study. Diabetes Res Clin Pract. 2020;166:108189.
• 25. Al-Arouj M, Bouguerra R, Buse J, Hafez S, Hassanein M, Ibrahim MA, et al. Recommendations for management of diabetes during Ramadan. Diabetes Care 2005;28(9):2305-11.
• 26. Hui E, Bravis V, Salih S, Hassanein M, Devendra D. Comparison of Humalog Mix 50 with human insulin Mix 30 in type 2 diabetes patients during Ramadan. Int J Clin Pract. 2010;64(8):1095-9.
• 27. Benbarka MM, Khalil AB, Beshyah SA, Marjei S, Abu Awad S. Insulin pump therapy in Moslem patients with type 1 diabetes during Ramadan fasting: an observational report. Diabetes Technol Ther. 2010;12(4):287-90.
• 28. Hassanein M, Malek R, Shaltout I, Sahay RK, Buyukbese MA, Djaballah K, et al. SoliRam Study Investigators. Real-world safety and effectiveness of iGlarLixi in people with type 2 diabetes who fast during Ramadan: The SoliRam observational study. Diabetes Metab Syndr 2023;17(2):102707.
• 29. Hassanein M, Malek R, Al Sifri S, Sahay RK, Buyukbese MA, Djaballah K, et al. Safety and Effectiveness of Concomitant iGlarLixi and SGLT-2i Use in People with T2D During Ramadan Fasting: A SoliRam Study Sub-analysis. Diabetes Ther 2024;15(11):2309-22.
• 30. Al Hayek A, Al Dawish MA. Improvement of Glycemia Risk Index and Continuous Glucose Monitoring Metrics During Ramadan Fasting in Type 1 Diabetes: A Real-World Observational Study. J Diabetes Sci Technol. 2024:19322968241301750.