Effect of Ramadan fasting on glycemic control in patients with Type 2 diabetes

Background: Although Muslim patients with Type 2 diabetes may be exempt from fasting during Ramadan for medical reasons, a high proportion of them fast. Aim: To investigate the association between Ramadan fasting and glycemic control in patients with Type 2 diabetes. Subjects and methods: A prospective cohort clinical trial was designed. Eighty-eight patients with Type 2 diabetes (45 male, 43 female, age 51 +/- 10 yr) who opted to fast for at least 10 days during the month of Ramadan were recruited. Fasting blood samples were taken at the beginning and end of Ramadan, and 1 month after Ramadan, to assess fasting blood glucose (FBG), fasting insulin, full blood count, glycated hemoglobin (HbA(1c)) and fasting lipid profile. Insulin resistance was estimated using the homeostatic model assessment. Anthropometrics and blood pressure were also measured. Results: There was a significant deterioration in FBG and HbA(1c) (p=0.002 and p <= 0.001, respectively) and significant improvements in HDL and LDL cholesterol and body mass index after Ramadan (p<0.001). Interestingly, HbA(1c) showed a reduction 1 month after Ramadan (9.4 +/- 2% at the end of Ramadan vs 8.4 +/- 2.5% 1 month after Ramadan; p<0.001). Conclusion: Results from this study showed that fasting during Ramadan deteriorated the glycemic control in Type 2 diabetes patients. This was more evident in patients using oral hypoglycemic medication than diet-controlled patients. However, Ramadan fasting had small positive effects on lipid profile and body weight. (J. Endocrinol. Invest. 35: 766-771, 2012) (c) 2012, Editrice Kurtis