Rapidly Controlled Diabetes Mellitus: A Six-month Experience with the Ramadan Fasting Effect
DOI:
https://doi.org/10.21649/akemu.v31iSpl2.5783Keywords:
Type II diabetes mellitus, Hyperosmolar nonketotic diabetic coma, Metformin, Ramadan, HbA1c, lifestyle change.Abstract
This is a brief case reporting a type-II diabetic patient with poor glycemic control that improved after diet/lifestyle change, coinciding with fasting during Ramadan.
A 47-year-old patient presented with severe polyurea, polydipsia, vision disturbances, and sudden weight loss of 10 kg. The initial check showed a high random glucose level (514 mg/dL) that was confirmed with a high HbA1c (17 mmol/L), but without any hyperosmolar nonketotic diabetic coma (HHNC) and with a remarkable visual deterioration. The patient underwent immediate medical intervention by administering metformin (500 mg/BID). The patient underwent complete pharmacotherapy in conjunction with diet control and lifestyle change during and after the Ramadan month.
After one month, all the hyperglycemic symptoms subsided significantly, even the visual complaints. Rapid reduction of the estimated glucose level (HbA1c, from 17.63 to 5.8) in six months was reported, returning to normal vision level, and body weight was restored (77.6 – 82 Kg).
References
1. Kelkar S, Muley S, Ambardekar P, Kelkar S, Muley S, Ambardekar P. Perioperative Diabetic Emergencies. In: Towards Optimal Management of Diabetes in Surgery. Singapore: Springer. 2019: 29-62. https://doi.org/10.1007/978-981-13-7705-1_2.
2. Glaser N, Fritsch M, Priyambada L, Rewers A, Cherubini V, Estrada S, et al. ISPAD clinical practice consensus guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2022;23(7):835-56.
3. Long B, Willis GC, Lentz S, Koyfman A, Gottlieb M. Diagnosis and management of the critically ill adult patient with hyperglycemic hyperosmolar state. J Emerg Med. 2021;61(4):365-75.
4. Mustafa OG, Haq M, Dashora U, Castro E, Dhatariya KK, Group JBDSfIC. Management of hyperosmolar hyperglycaemic state (HHS) in adults: an updated guideline from the Joint British Diabetes Societies (JBDS) for Inpatient Care group. Diabet Med. 2023;40(3):15005.
5. Bergman M, Buysschaert M, Ceriello A, Hussain A, Mohan V, Sesti G, et al. Current diagnostic criteria identify risk for type 2 diabetes too late. Lancet Diabetes Endocrinol. 2023;11(4):224-6.
6. Farhood BR, Abdulwahhab MM. Effectiveness of the Educational Program on Nurses’ Knowledge concerning Hyperosmolar Hyperglycemic State. Alq J Med App Sci. 2024;(1):689-97.
7. Zahran NA, Jadidi S. Pediatric hyperglycemic hyperosmolar syndrome: A comprehensive approach to diagnosis, management, and complications utilizing novel summarizing acronyms. Children. 2023;10(11):1773.
8. Ortiz-Martínez M, González-González M, Martagón AJ, Hlavinka V, Willson RC, Rito-Palomares M. Recent developments in biomarkers for diagnosis and screening of type 2 diabetes mellitus. Curr Diab Rep. 2022;22(3):95-115.
9. Alali SM, Alghamdi RL, Al Bosrour ZA, Al Dokhi AAA, Alabdulrahim ZA, Almazyad AZA, et al. Role of Physicians in Diagnosis and Management of Diabetes Mellitus in Primary Health Care. Arch. Pharm. Pract. 2019;10(2):12-5.
10. Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes care. 2016;39(11):2065.
11. Grammatiki M, Sagar R, Ajjan RA. Metformin: is it still the first line in type 2 diabetes management algorithm? Curr Pharm Des. 2021;27(8):1061-7.
12. Villikudathil AT, Mc Guigan DH, English A. Exploring metformin monotherapy response in Type-2 diabetes: Computational insights through clinical, genomic, and proteomic markers using machine learning algorithms. Comput Biol Med. 2024;171(1):108106.
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