Endocrine Abstracts

Introduction: As Ramadan fasting is one of the five pillars of Islam, more than one billion muslims fast simultaneously worldwide. Patients with diabetes especially those with type 1 diabetes who fast during Ramadan, are at increased risk of diabetic ketoacidosis, particularly if their diabetes is poorly controlled before Ramadan. The aim of our study was to compare the incidences of diabetic Ketosis or ketoacidosis during in the month of Ramadan, the preceding month (Shaaban), and the following month (Shawal).

Methods: We performed a prospective study that included all known diabetic patients admitted with diabetic ketosis or ketoacidosis in the different departments of the National Nutrition Institute of Tunis during the pre-Ramadan month, Ramadan and post Ramadan month of 2 years 2015 and 2016. Demographics, clinical, and laboratory indices were collected.

Results: Total number of patients who were admitted with diabetic ketosis or ketoacidosis was 136 patients, 42 during Shaaban, 38 during Ramadan and 56 during Shaawal. There was no significant difference in the number of patients admitted with ketosis or keto acidosis during the three periods (P=0.425). The duration of acidosis during Ramadan (19±24 h) was slightly higher than the others periods (17±18 hours before and 15±10 hours after) (P=0.906). During Ramadan, 58% of patients were with type 1 diabetes, 43% before Ramadan and 48% after Ramadan (P=0.013). The mean age of patients during Ramadan was significantly lower than during the two other periods (P=0.027). Non-compliance was the main precipitating factor during in the whole study periods.

Conclusion: Our study showed no significant difference in the incidence of ketosis or ketoacidosis during Ramadan compared to preceding and later months (Shaaban and Shaawal). Structured education seems to be important to avoid these diabetic complications during Ramadan.