International Journal of Women's Health (Mar 2022)
Fructosamine as an Index of Short-Term Glycemic Control in Pregnant Women with Diabetes: Before, During and After Ramadan
Abstract
Aishah Ekhzaimy,1 Shadin Alkatari,1 Mohamed AlMaatouq,1 Daad Alotaibi,1 Sarah Aljasser,1 Amal Aseeri,1 Anwar Jammah,1 Muhammad Mujammami,1– 3 Mona Fouda,1 Assim A Alfadda,1,2,4 Riad Sulaimani1 1Division of Endocrinology, Department of Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia; 2Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia; 3University Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia; 4Obesity Research Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi ArabiaCorrespondence: Aishah Ekhzaimy, Division of Endocrinology, Department of Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia, Email [email protected]: Impact of ramadan fasting on healthy and women with diabetes is already known. However, there is a scarcity of data on impact of fasting on pregnant women with diabetes. Moreover, religious and medical recommendations advise pregnant women against fasting as it is unsafe. Despite being exempted, many pregnant Muslim women with diabetes still choose to fast during ramadan. This study investigated different glycemic marker as an indicator for diabetes control in fasting pregnant women.Patients and Methods: This is a prospective observational study. A total of 89 pregnant diabetes women were recruited. Blood glucose was self-monitored in all the pregnant women using glucose monitoring device at home. We measure the fructosamine, HbA1c levels before, during and after ramadan.Results: Pregnant women with type 1 diabetes were 14 (25%), type 2 diabetes were 21 (37.5%), and gestational diabetes were 21 (37.5%). The mean fructosamine level decreased during and after ramadan in gestation diabetes pregnant women compared to type 2 diabetes and type 1 diabetes pregnant women subjects (p = 0.009).Conclusion: The present study indicates that pregnant women with diabetes were able to fast during ramadan and there fructosamine level reduced during fasting. Utilization of fructosamine for short-term monitoring of glycemic control in addition to home glucose monitoring in pregnant women with diabetes will provide a good index of glycemic control.Recommendation: Religious and medical recommendations advise pregnant women against fasting as it is unsafe, and they are under high risk. However, if they insist to do fast, they must do under strict medical supervision and fructosamine can be used as a glycemic control marker.Keywords: ramadan fasting, gestational diabetes, type 2 diabetes, type 1 diabetes, pregnant women, fructosamine