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During the initial hours of fasting, the body uses up its glycogen stores as an energy source. Once these glycogen reserves are depleted, the body begins breaking down stored triglycerides and structural proteins. During this stage, glycerol becomes a key substrate for gluconeogenesis, while free fatty acids undergo beta-oxidation to provide energy for tissues, such as skeletal muscle. In the fasting state, the body spares protein breakdown as much as possible to conserve muscle and structural...
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Fasting with diabetes: a prospective observational study.

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Many diabetic patients experience adverse glycaemic events like hypoglycemia and hyperglycemia when fasting regularly. Consulting a physician before fasting can reduce the risk of these events.

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Public Health

Background:

  • Fasting is common among diabetic patients, yet carries risks of adverse glycaemic events.
  • Lack of physician consultation before fasting can lead to medication and lifestyle mismanagement.
  • Understanding the prevalence of these events is crucial for patient safety.

Purpose of the Study:

  • To determine the proportion of diabetic patients experiencing adverse glycaemic events during regular fasting.
  • To identify factors associated with an increased risk of hypoglycaemia and hyperglycaemia.

Main Methods:

  • Prospective observational study including 150 diabetic patients aged over 18.
  • Patients regularly fasted and monitored daily blood glucose levels.
  • Hypoglycaemic and hyperglycaemic events were primary outcomes; relative risk was calculated.

Main Results:

  • 10% of participants experienced hypoglycaemia, and 3.3% had hyperglycaemic episodes.
  • 8.7% discontinued fasts, but none required hospitalization.
  • Pre-fasting physician consultation showed a negative association with hypoglycaemia risk (RR 0.73).

Conclusions:

  • Regular fasting poses a significant risk of adverse glycaemic events for diabetic patients.
  • Many patients do not consult physicians for medication/lifestyle adjustments before fasting.
  • Patient education and strategic interventions are vital to prevent complications.