Endocrine Abstracts

Ramadan is a month for Muslims during which they abstain from eating, drinking and smoking from dawn to sunset. The recommendations regarding the safety of fasting for type 2 diabetic patients have been based on expert opinion rather than evidence based medicine and sometimes controversial. In this study, we looked at the effect of Ramadan fasting on glycaemic control of type 2 diabetic patients on oral hypoglycaemic agents.

Eighty-eight diabetic patients (45 males and 43 females, mean age 51±10 years) on oral hypoglycaemic agents with a stable glycaemic control 3 months prior to the Ramadan were recruited. Local research ethics committee approval obtained. The subjects should have been fasting for at least 10 days (out of 29 days) during month of Ramadan. Fasting blood samples were taken at the beginning, at the end and 1 month after Ramadan. Anthropometric values, fasting blood sugar (FBS), insulin, lipids profile and HbA1c were measured at these time-points.

There was a significant deterioration in FBS and HbA1c after Ramadan (P<0.005, paired t-test). There was also a significant improvement in HDL level after Ramadan (P<0.005, paired t-test). Interestingly, the HbA1c showed a reduction 1 month after Ramadan (HbA1c 8.4±2% 1 month after Ramadan; P<0.005, paired t-test).

This study shows fasting during Ramadan deteriorates the glycaemic control in type 2 diabetic patients. The glycaemic control was improved 1 month after Ramadan. Also there was a significant improvement in HDL value. However, measuring other short-term markers of the glycaemic control such as fructosamine and a study with a bigger sample size, controlling other habitual changes and a control group is needed.