Endocrine Abstracts

Aim: The objective of our study is to describe the evolution of the parameters of the lipid balance after fasting in a population of diabetic women, and to determine if the BMI before the fast is associated with the variation of these parameters.

Materials and methods: This is a prospective evaluative study conducted on 44 female patients with type 2 diabetes who have received prior education and therapeutic adjustment adapted according to the recommendations of the ADA 2016.

Results: The mean age was 53.31 ± 11.93 years. The average BMI was 30.33 ± 5.26 kg/m². 73.3% (n = 33) were at high and very high risk related to fasting (ADA 2016). The days fasted were successive with an average of 24.75 ± 8.7 days. The majority (73.3%, n = 33) had fasted for the entire month. 77.6% (n = 35) were obese with an average BMI of 31.78 ± 4.4 kg/m². There was no significant difference between patients with normal BMI and those who were obese in terms of average age and average number of fast days. HbA1C decreased from 8.49 ± 1.73% to 8.16 ± 1.89% after fasting (P = 0.079). The CT, TG, HDL and LDL were respectively 4.67 ± 0.88, 1.2 ± 0.44, 1.15 ± 0.24 mmol/l and 1.15 ± 0, 31 g/l before fasting, respectively. They increased respectively after fasting to 4.62 ± 0.88 (P = 0.613), 1.27 ± 0.4 (P = 0.197), 1.16 ± 0.24 mmol/l (P = 0.873) and at 1.11 ± 0.3 g/l (P = 0.326). Either an average decrease of –0.04 ± 0.62 mmol/l of CT, an average increase of +0.07 ± 0.35 mmol/l of TG, an average increase of +0.005 ± 0.21 mmol/l in HDL and an average decrease of –0.039 ± 0.26 g/l in LDL. In obese, the mean change in CT was –0.15 ± 0.57, mmol (+036 ± 0.68 mmol/l in the case of normal BMI, P = 0.025). The TG was +0.04 ± 0.37 mmol/l (+0.17 ± 0.29 mmol/l (normal BMI), P = 0.349). The HDL values were –0.004 ± 0.2 mmol/l (+0.04 ± 0.25 mmol/l (normal BMI), P = 0.57). And that of LDL was –0.07 ± 0.25 g/l (+0.07 ± 0.27 g/l (normal BMI), P = 0.139). Thus, BMI was associated only with the variation in CT in our population.

Conclusion: The literature reports disparate results in terms of variation in lipid parameters after the fast of the month of Ramadan. They remain highly sensitive to several factors including diet. Studies on a larger scale are essential to better characterize these variations.