Endocrine Abstracts

Introduction: The objective of our study was to study the evolution of the weight of a population of diabetic patients previously educated and having fasted the month of Ramadan.

Methods: This is a prospective study that involved 140 patients who wish to fast the month of Ramadan (2016) and who have presented themselves at consultations dedicated to preparing diabetic patients wishing to fast, organized at the National Institute of Nutrition of Tunis (Departement C). These patients were given an interview, a thorough clinical examination and a biological assessment and were well informed about the risks they face. They had the appropriate therapeutic adaptation (ADA recommendations of 2010), as well as adequate hygiene and dietary education. We have totally banned fasting for unbalanced patients.

Results: The average number of days fasted was 24.57±10.5 days. The sex ratio was 0.94.The average age was 55.75±10.83 years. Diabetes has averaged 8.17±6.9 years, poorly balanced in 71% of cases. 23% were insulin-dependent. The average fasting glucose level was 9.74±3.76 mmol/l. The mean HbA1C was 8.28±1.61%. The mean body mass index was 29.19±5.03 kg/m². 20% had a normal corpulence with an average BMI of 23±1.68 kg/m². The others were either overweight or obese with an average BMI of 30.73±3.51 kg/m². After fasting, there was a slight weight gain of 0.05 kg, with no significant difference compared to the weight before fasting. This weight gain was seen in patients with normal body size and those with overweight or obese with averages close to 0.05 kg and 0.06 kg respectively. The frequency of weight gain was the same (21.44%),for both normal and overweight/obese patients. The weight loss was more marked in overweight or obese patients with a frequency of 24.11% compared to 10.71% in patients of normal body size. Weight loss was between 2 and 3 kg in normal body weight, and 1 to 2 kg in overweight or obese subjects. The weight gain was 0.5 to 2 kg and 1 to 4 kg, respectively. The weight remained stable in more than 50% of patients regardless of their initial body size.

Conclusion: The change of the weight in diabetic patients after Ramadan fasting depends on several parameters such us BMI before the fast. It involves changes in insulin sensitivity, changes in the sleep cycle often interrupted by the ‘shour’ meal and changes in the composition of specific dishes of the month of Ramadan.