Endocrine Abstracts

Long fasting in patients with adrenal insufficiency could cause hypotension, dehydration or hypoglycaemia. No studies evaluated these risks and there is no recommendations about fasting for these patients. The aim of our study was to evaluate the potential risks of fasting during the month of Ramadan in patients with adrenal insufficiency.

Subjects and methods: It is a cross sectional study that concerned 125 subjects (97 women and 28 men, mean age=47.8 years) followed up and treated for adrenal insufficiency (primary in 34 cases and secondary in 91 cases). These patients were questioned about fasting during the last month of Ramadan; changes in the modalities of the treatment, eventual complications, number of fasted days, and were evaluated about their disease knowledge. The mean duration of daily fast during Ramadan 2014 in Tunis was about 14 h.

Results: Fasting was allowed by the physician in 11 cases (8.8%). 59 patients tried to fast: 36 patients (28.8%) could complete the fast of the whole month and 23 patients (18.4%) stopped fasting for fatigue in 20 cases, hypoglycaemia in four cases, dehydration (thirst, hypotension) in 12 cases. Four patients were hospitalized for acute adrenal insufficiency. Compared to patients who could fast the whole month, patients who stopped fasting had a more advanced age (49.3 years vs 47.1 years), more frequently a primary adrenal insufficiency (27% vs 17%) and a longer duration of the disease (10.6 years vs 8.7 years).

Conclusion: Fasting during Ramadan can be complicated especially in aged patients, a longstanding disease and a primary origin. More studies are needed and a consensus should be established for safe fasting in patients with adrenal insufficiency.