The impact of Ramadan fasting on glucose variability in type 2 diabetes mellitus patients on oral anti diabetic agents

PLoS One. 2020 Jun 29;15(6):e0234443. doi: 10.1371/journal.pone.0234443. eCollection 2020.

Abstract

Ramadan fasting is associated with changes in eating, physical activity, sleeping patterns, and medication. Unfortunately, only limited studies examine glucose variability in subjects with type 2 diabetes who fast in Ramadan. Our study aims to evaluate glucose variability in subjects with type 2 diabetes on oral antidiabetic agents using continuous glucose monitoring system (CGMS) during and after Ramadan fasting. This observational study was done in The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia, which recruited 10 subjects with type 2 diabetes who underwent Ramadan fasting in 2019. These subjects were free from cardiovascular disease, kidney disease, severe liver disease, chronic gastrointestinal disease and autoimmune disease. Insertion of CGMS for measuring interstitial glucose was performed after at least 2 weeks of Ramadan fasting and 4 weeks after the end of the Ramadan fasting, with a minimum of 3 days observation. The mean amplitude of glycemic excursion (MAGE) during and after Ramadan were similar (p = 0.94). In line with this, the average interstitial glucose (p = 0.48), the maximum interstitial glucose (p = 0.35), the minimum interstitial glucose (p = 0.24), and the duration of hypoglycemia (p = 0.25) were also similar in both periods. Overall, nutritional intake and energy expenditure during both periods were comparable. Ramadan fasting is not associated with increased glucose variability in subjects with type 2 diabetes. Thus, Ramadan fasting is safe in subjects with type 2 diabetes with no complications.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Blood Glucose / analysis
  • Blood Glucose / drug effects
  • Blood Glucose / physiology*
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / physiopathology
  • Energy Metabolism / physiology
  • Fasting / physiology*
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Indonesia
  • Islam*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Monitoring, Ambulatory
  • Prospective Studies

Substances

  • Blood Glucose
  • Hypoglycemic Agents

Grants and funding

Q1Q2 Grant (NKB-0219/UN2.R3.1/HKP.05.00/2019) from Faculty of Medicine Universitas Indonesia was granted to Dicky Levenus Tahapary. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.