Endocrine Abstracts

Introduction: Diabetes is considered by some to be a burden, it is common to meet diabetic Muslims who wish to observe the fast of the month of Ramadan. The objective of our work was to observe the effect of Ramadan fasting on clinical and metabolic parameters in type 2 diabetics.

Patients and methods: Prospective study including 160 diabetic patients, within the Endocrinology department from May to August 2018. The participants benefited from a pre (T0), per and post-Ramadan (T1) education. Anthropometric measurements and biological parameters were performed during these periods. Statistical analysis done by Spss version 25.0.

Results: We found 68.75% of fasting and 31.25% of non-fasting, a sex ratio of 0.7 H/F, a mean age of 53.3±11.2 years, low school level in 70.6% and a family life of 81.2%. The duration was 10±8 years, an irregular follow-up in 10.6%. An average HBA1c of T0: 8±2%, T1: 7.5±1.3%, P=0.07. Complications identified were: 38% hypoglycemia, 39% hyperglycemia, 35% retinopathy, 20.6% nephropathy, 27% neuropathy, 14.4% coronary artery disease, 34.4% hypertension, and dyslipidemia of 35.6%. The clinical examination noted an average BMI of 32.4±8 kg/m² and a controlled blood pressure of 13±1.6 cmhg. As dietary intakes were reduced, we noted a 2.3±1 kg weight loss after Ramadan, a significantly improved fasting blood glucose level: 1.36±0.4 vs 1.46±0.4 g/l (P=0.0001). At the paraclinical, a decrease in LDL and total cholesterol of 0.25±0.2 g/l (P<0.0001), an increase in HDL of 0.06 g/l. We did not notice any difference for triglycerides, calcemias and protidemias. In contrast, a decrease in serum uric acid of 4.74±1 mg/l.

Conclusion: These data suggest that fasting could be particularly beneficial for the diabetic as a nutritional intervention. However, these effects may be transient, given the short duration of the Ramadan period, which exposes to risks of complications or deterioration of metabolic control due either to the observance of fasting or the disruption of food intake.