Endocrine Abstracts

Introduction: The purpose of this study was to describe the clinical and metabolic characteristics of a population of diabetic patients previously educated and having fasted all month of Ramadan.

Methods: This is a prospective study that involved 140 patients who wish to fast the month of Ramadan (2016).They 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 recommandations of 2010), as well as an adequate hygiene and dietary education. We have totally banned fasting for unbalanced patients.

Results: Of the 140 patients, 102, all diabetics type 2,fasted all month of Ramadan. The average age was 56.83±10.77 years. The sex ratio was 0.8.The average weight was 79.21±14.08 kg. Diabetes was evolving since 8,4±6.8 years on average. 20.4% of cases were insulin-dependent. 69% were unbalanced and fasted against medical advice. 26.5% were hypertensive and 27.46% were dyslipidemic. Mean systolic and diastolic arterial blood pressure was 12.71±1.48 and 7.35±0.78 mmHg, respectively. Fasting glucose averages and HbA1C were respectively 9.37±3.68 mmol/l and 8.1±1.58%. According to the glycemic equilibrium before fasting.Fasting blood glucose was respectively 7.82±3.52 mmol/l in well-balanced patients and 10.09±3.55 mmol/l in unbalanced ones. HbA1C was respectively 6.37±0.45 mmol/l in well-balanced patients and 8.89±1.26 mmol/l in unbalanced ones. The mean clearance of creatinine was 98.17± 21.37 ml/min. 4 cases of moderate hypoglycemia and 11 cases of hyperglycemia greater than 3 g/l were reported, but patients continued to fast. No other metabolic complication had occurred. After fasting, the average weight was 79.01±14.19 kg. The systolic and diastolic arterial blood pressure averages were 12.74±1.18 and 7.5±0.7 mmHg, respectively. Fasting blood glucose and HbA1C were 8.99±3.15 mmol/l and 8.1±1.57%, respectively. Fasting glucose was 7.8±2.22 mmol/l in balanced patients and 9.54±3.36 mmol/l in unbalanced one. HbA1C values were 6.47±1.01 mmol/l for balanced patients and 8.47±1.37 mmol/l in unbalanced one. Mean creatinine clearance was 98.04±21.88 ml/min.

Conclusion: In our population, the fasting of the whole month of Ramadan had been well tolerated with an improvement in the poorly balanced glycemic patients.Studies with larger numbers are needed to better characterize the effect of fasting on clinical and metabolic parameters.