Impact of Socializing, Fasting and Feasting on Day to Day Blood Glucose Profiles in Diabetes Elucidated by the FreeStyle® Libre^™ System

Background: Total day-time fasting is observed by millions of adult Muslims during the whole lunar month of Ramadan. However, many people, particularly elderly men and women, do fast isolated or somehow consistent days outside Ramadan. This may pose clinical management challenges. Case Report: A case of an elderly diabetic man observing day-time Ramadan-type fasting on Mondays and Thursdays throughout the year is described. Detailed blood glucose (BG) profiles over a 10 week period were captured using the FreeStyle® Libre^™ Flash glucose monitoring system. Detailed study of these profiles revealed three distinctly different BG patterns every week. One pattern on the two fasting days (Mondays and Thursdays) with blood glucose peaking after dawn and after sunset with a downward trend throughout the day. A second pattern on Fridays with the BG levels that peak and remain high for a few hours in the early afternoon following the large and rich weekly family meal. The third pattern was seen on the remaining 4 non-fasting days where BG starts to rise in the midmorning reflecting the patient's life style of hosting and sharing with his business clients. Such detailed and visually presented information gave insights into his BG daily patterns enabling his therapeutic plans for hyperglycemia to be tailored on daily basis. Conclusions: This is the first documentation of glucose profiles during “Ramadan-type fasting” and feasting using the flash glucose monitoring system. In addition to detailed clinical and social history, use of medical technology may occasionally help resolve some difficult blood glucose patterns.

Key-words:

Continuous glucose monitoring (CGM) systems - Diabetes in the Elderly - Hyperglycemia - Hypoglycemia - Ramadan-type fasting - FreeStyle® Libre^™ Flash glucose monitoring system - Ethnicity and Diabetes.

Publication History

Received: 24 May 2016

Accepted: 08 June 2016

Article published online:
07 July 2022