Endocrine Abstracts

Introduction: Ramadan fasting is one of the sacred rites in Islam. Diabetes patients are spared this obligation. However, mostof them insists on fasting.

The aim of this study is to assess the clinical and metabolic impact of Ramadan fasting in Tunisia patients with diabetes during Ramadan 2019.

Materials and methods: Prospective descriptivestudy carried out during Ramadan 2019 including 86 diabetic patients followed at the National Institute of nutrition of Tunis. Clinical and metabolic data were recordedfrom patients’ files, as well as by conducting individual interviews and physical exam. The period of our study covered one to three months before Ramadan and one month after it.

Results: The mean age was 55.8 ± 12.7 (23–80 years). The sex ratio was 1,08 (F/M). The average BMI was 28.22 ± 4.22 kg/m². Most of patients had type 2 diabetes (97.7%). The average duration of diabetes was 10.6 ± 6.6 years. Patients were treated with oral anti-diabetics alone, insulin or the association between the two, in 50%, 13% and 37% of cases respectively. Two thirds of patients were classified as high to very high risk for fasting and 32.3% had a low or intermediate risk. Only 30% were educated, 24% before one month, 4% before two months and 2% before three months. Half ofof participants (55%) experienced a weight loss after Ramadan, 28% a weight gain, and 18% no change in weight. Furthermore, we did not objectify a relationship between the change in BMI and initial BMI. Regarding the metabolic impact, we noted a significant increase in mean HbA1c (8 ± 1.2 vs 8.7 ± 1.35; P < 0.01), but not significant in Triglycerides and glomerular filtration rate while we noticed a non-significant decrease in total cholesterol, LDL cholesterol, HDL cholesterol and uric acid. We did not notice a significant difference inthe parameters studied between educated and uneducated patients. The main complications were hypoglycaemia (18,65%) and hyperglycaemia (5.8%). Otherwise, No acute metabolic accident or hospitalization were reported.

Conclusions: Ramadan fasting had a negative impact on glycemic balance, and a variable effect on the lipid profile and weight status. This underlines the importance ofimprovingthe education of patients with diabetes to avoid acute complications during this month.