Biometric and metabolic changes in patients with diabetes prior, during and after the holy month of Ramadan (ABCD Study)

Diabetes Res Clin Pract. 2021 Mar:173:108678. doi: 10.1016/j.diabres.2021.108678. Epub 2021 Jan 28.

Abstract

Physiological impact of the intermittent or prolonged fasting is known from various studies on healthy subjects. However, data on impact of fasting on biochemical and biometric parameters in people with diabetes is building up. Safety of Ramadan fasting has always been assessed after Ramadan. This study looked into the immediate effect of fasting during the fasting days compared to time before and after the fasting month.

Methods: This is an observational study. We looked into people with biometric and biochemical records before Ramadan, and we followed them up during and after Ramadan prospectively. We were aiming for assessing the biochemical and biometric changes for people with diabetes during Ramadan in comparison to pre-and post Ramadan. As well as the differences between these measures according to type and treatment of diabetes in those who fasted as well as in those who did not fast during Ramadan.

Results: Total of 342 patients were recruited to the study. All were patients with diabetes at a mild to moderate risk of complications if fasted. Majority were males 52.3% (n = 180), while females were 47.7% (n = 162). Most of the results showed a U shape between Pre-Ramadan, During Ramadan and Post-Ramadan periods. there was a modest but significant reduction in weight but regained after Ramadan.

Conclusions: Our study suggests that for many people with diabetes fasting is not associated with an increased risk to their glycemic control, their weight and/or their blood pressure. Indeed, what is seen is marginal benefit or no change in all parameters. This stratifies the ongoing recommendation that allows patients with categorized as low risk to fast Ramadan or non-Ramadan days whenever desired.

Keywords: Biochemical changes in Ramadan; Diabetes; Diabetes and Ramadan; Fasting; Low risk.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biometry / methods*
  • Diabetes Mellitus, Type 2 / blood*
  • Fasting / blood*
  • Female
  • Humans
  • Islam
  • Male
  • Middle Aged
  • Prospective Studies
  • Young Adult