Endocrine Abstracts

Introduction: Fasting the month of Ramadan is practiced by more than one billion Muslims worldwide, including type 2 diabetic patients. Its effects on body composition and body weight in type 2 diabetic patients are controversial.

The objective of our study was to assess the evolution of anthropometric parameters as well as the body composition in type 2 diabetic patients who fasted the month of Ramadan.

Methods: We conducted a prospective case–crossover study including 55 type 2 diabetic patients treated with metformin and / or sulphonylurea, with an HbA1c <10% and who intended to fast the month of Ramadan 2019, in the absence of a major contraindications. Body composition and anthropometric parameters (body weight, body mass index (BMI) and waist circumference (WC)) were evaluated in three sessions: T0: before the month of Ramadan, T1: just after the month of Ramadan and T2: 1 to 2 months after Ramadan month.

Results: Participants had an average age of 54.5 ± 10.1 years and a sex–ratio of 0.89. The average HbA1c before the month of Ramadan was 7.13 ± 0.95%. Eighty–nine percent of patients fasted 30 days. There was a significant body weight loss after Ramadan fasting (p < 10^–3). The BMI was 29.51 ± 5.13 kg/m² before Ramadan, 29.22 ± 5.42 kg/m² at T1 (P = 0.004) and 29.56 ± 5.01 kg/m² at T2 (P = 0.05). The WC clearly decreased at T1 (T0 = 97.6 ± 8.92 cm vs T1: 96.37 ± 10.22 cm; P = 0.015) but not at T2 (WC = 97.13 ± 8.03, P = 0.55). Compared to T0, there was a decrease in the fat mass at T1 (T0 = 23.69 ± 9.32% vs T1 = 23.28 ± 9.5%, P = 0.043) but not at T2 (T2 = 23.77 ± 9.26%, P = 0.24). The fat mass index varied from 8.92 ± 3.92 at T0 to 8.82 ± 4.12 at T1 (P = 0.04) and to 8.93 ± 3.76 at T2 (P = 0.24). Body weight loss at T1 was positively correlated with the number of fasted days (r= 0.348, P = 0.018). However, it was not correlated with dietary intake variations and the physical activity.

Conclusion: Ramadan fasting had a favorable and a significant effect on the body composition, the body weight and the WC in type 2 diabetic patients. However, this improvement was not sustainable one month later.