Endocrine Abstracts

Introduction: Fasting during the month of Ramadan is a religious rite. Fasting is not without risks in diabetic patients. Several recommendations and consensus of experts have recently made it possible to establish proposals to optimize the management of diabetes during Ramadan, and to specify the authorized population for this sacred practice.

Purpose of the study: To assess the prevalence of type 2 diabetics authorized to fast according to the DAR 2021 recommendations and to compare it with that of the old IDF 2016 classification.

Method: Descriptive prospective study, including diabetics type 2 wishing to fast, followed in the endocrinology and metabolic diseases department of the CHU Ibn Rochd in Casablanca from April to June 2021.

Results: Our study included 91 type 2 diabetic patients with an average age of 58.7 years. The average duration of diabetes was 9.5 years. The average HbA1c was 8.1%, 42% of our patients were on insulin, 43% were on sulfonylureas (SH). In order to compare the recommendations, we classified our patients into 3 groups: group 1: Authorized to fast by the 2 classifications (25.3%), group 2: Not authorized according to the 2 classifications (35.2%) and group 3: 39.5% authorized fasting only by DAR. Among the group 3, 27.7% were on insulin therapy, 33.4% on SH. Acute complications, mainly hypoglycaemia, were observed in 44.5% of these patients.

Conclusion: The latest DAR 2021 recommendations allow a very large diabetic population to fast in Ramadan compared to the old classification. Waiting for more cautious recommendations, the fasting decision must be adapted to each patient, even when the risk score is reassuring.