Endocrine Abstracts

Background and aims:

The objective of our study is to evaluate the respect of Muslim diabetics for the contraindication of fasting and the control metabolic impact of fasting during the month of Ramadan.

Materials and methods:

This analytical cross-sectional study was conducted during the period from Mars to June of the year 2021, within the department of endocrinology and metabolic diseases of the Military Hospital of Instruction Mohamed V of Rabat.

Results:

Among the 89 patients included in our study, 54 (60%) fasted against their physician's advice, among whom 77.77% had a low level of education (versus 71.4%) (p=0.498), the age of diabetes (p=0,004), the presence of degenerative complications(p<0,001), and the degree of glycemic control(p=0,018) were the main predictors of fasting against medical advice. The mean HbA1C level in the patients who decided to fast was 7.77+/- 1.6% before Ramadan and 7.79+/-1.56% after Ramadan, while that in the non-fasting group was 8.84+/-2.34% before Ramadan and 8.58+/- 1.89% after Ramadan. Hypoglycemia concerned 37% of the patients who fasted( versus 0%) (p<0.001).

Discussion:

Of the 89 patients who were not allowed to fast, more than half( 60%) fasted during the month of Ramadan. This result is similar to that of the study by Meriem Bencharif and al , in which 58.5% of patients with type 2 diabetes fasted during the holy month , The EPIDIAR study , found that among type 2 diabetics, 78.7% fasted for more than 15 days of the holy month.

 In our study , patients with long-standing diabetes tend to comply with their doctor's instructions; this can be explained by the improvement of the knowledge of diabetics regarding their disease with time as proved by the study of C. Bel Hadj Sliman and al . The presence of degenerative complications, and the glycated hemoglobin level,  also influence, the attitude of diabetic patients during the month of Ramadan (p<0.001).

The EPIDIAR study  showed a significant increase in hypoglycemic events during Ramadan in diabetic patients, the same finding was noted in our study , Nevertheless, no change in the incidence of hypoglycemia was found in diabetic who fasted and were well controlled at baseline in several studies

Conclusion:

Our study proves that a large Muslim diabetic population does not respect the doctor's instructions when it comes to fasting during Ramadan.