Is Ramadan Fasting Safe in Type 2 Diabetic Patients in View of the Lack of Significant Effect of Fasting on Clinical and Biochemical Parameters, Blood Pressure, and Glycemic Control?

Background: There are variable effects of Ramadan fasting on clinical and biochemical variables of diabetic people. Anti-diabetic agents are often adjusted during this time to reflect changes in lifestyle. The study was conducted to understand the diversity of follow-up, treatment pattern, clinical, and biochemical outcome of Ramadan fasting among type 2 diabetic patients who observed Ramadan fast. Methods: This real-world, multi-center, prospective, observational study was conducted at the diabetes outpatient department of National Healthcare Network (NHN) Uttara Center of Bangladesh Diabetic Somity (BADAS), Dhaka, Bangladesh and outpatient department of MARKS Hormone and Diabetes clinic, MARKS Medical College &Hospital in Dhaka, Bangladesh upon randomly selected type 2 diabetic patients, recruited 1 to 12 weeks prior to the Ramadan and followed up till 12 weeks post-Ramadan period. Finally, a total of 271 participants completed satisfactory follow up. Data was collected before, during, and after Ramadan using a set of questionnaires in a face to face interview. Results: The majority (80.1%) of participants received pre-Ramadan education, counseling, adjustment of medication and other direction to help them cope with Ramadan fasting. A significant reduction of weight, body mass index (BMI)) and blood pressure were reported after Ramadan fast (p<0.001). None of the studied participants experienced severe hyper/hypoglycemia or acute complications requiring hospitalization or an emergency room visit. Metformin was the commonest prescribed anti-diabetic medication. Premixed insulin was the commonest insulin regimen during study period. Three most commonly adjusted oral anti-diabetic drugs were gliclazide, glimepiride, metformin and insulin doses were also adjusted. Mean of fasting and prandial capillary blood glucose decreased from pre-Ramadan period to post-Ramadan period (P<0.05). HbA1c decreased during post-Ramadan period compared to pre-Ramadan visit (P=0.13). A significant reduction in the triglyceride level was observed during post-Ramadan follow up (P< 0.05). Conclusion: The study revealed that a safe fasting can be observed with proper pre-Ramadan work-up. Ramadan fasting resulted into significant reduction of weight, BMI, blood pressure, lipid profile and improved glycemic status in patients with type 2 diabetes. Birdem Med J 2021; 11(1): 30-38

Download Full-text

Achievements of Diabetes Goals and Their Determinants in Type 2 Diabetic Patients Attending Outpatient Diabetic Clinic in Northern Ethiopia

International Journal of Chronic Diseases ◽

10.1155/2017/5713187 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Ezra Belay ◽

Abel Abera ◽

Aman Mehari ◽

Gidey Gebremeskel ◽

Asrat Endrias ◽

...

Keyword(s):

Blood Pressure ◽

Glycemic Control ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Duration Of Diabetes ◽

Type 2 Diabetic

Background. The aim of this study was to assess target diabetic goal achievements and to explore variables associated with them. Methods. A cross-sectional study was conducted between December 2015 and April 2016 on 188 type 2 diabetic patients attending Ayder Referral Hospital’s outpatient diabetic clinic. Glycemic control was assessed using fasting plasma glucose values and total cholesterol and triglyceride were used to evaluate lipid profiles. Bivariate and multivariate logistic regression analyses were done to identify factors associated with poor glycemic control, hypertension, and dyslipidemia. Result. Mean duration of diabetes was 6.5 years. Combined glycemic, lipid, and blood pressure targets were achieved only in 8.5% of the participants. More males achieved combined targets than females. Separately, while above two-thirds of the patients had poor glycemic control (67%), more than half of the participants have had poor lipid (58.5%) and blood pressure (52.1%) control. A significant portion of the patients (68.1%) had also comorbidities other than hyperglycemia. In bivariate and multivariate analyses, longer duration of diabetes disease (AOR: 3.4; P=0.013) and marked month to month fasting plasma glucose (FPG) variability as measured by large standard deviation (AOR: 2.5; P=0.023) were significantly associated with overall poor mean FPG results. Female sex was also significantly associated with dyslipidemia (AOR: 1.9; P=0.049). Conclusion. The study showed that achievements of combined diabetic goals are generally poor.

Download Full-text

Impact of Ramadan fasting on glycemic control in type 2 diabetic patients treated with insulin

10.26226/morressier.59d5184fd462b80296ca2c2e ◽

2017 ◽

Author(s):

Imen Sebai

Keyword(s):

Glycemic Control ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Ramadan Fasting ◽

Type 2 Diabetic

Download Full-text

Combined intensive blood pressure and glycemic control does not produce an additive benefit on microvascular outcomes in type 2 diabetic patients

Kidney International ◽

10.1038/ki.2011.415 ◽

2012 ◽

Vol 81 (6) ◽

pp. 586-594 ◽

Cited By ~ 39

Author(s):

Faramarz Ismail-Beigi ◽

Timothy E. Craven ◽

Patrick J. O'Connor ◽

Diane Karl ◽

Jorge Calles-Escandon ◽

...

Keyword(s):

Blood Pressure ◽

Glycemic Control ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic ◽

Intensive Blood Pressure

Download Full-text

Influence of Ramadan Fasting on Hemoglobin A1C, Lipid Profile, and Body Mass Index among Type 2 Diabetic Patients in Najran City, Saudi Arabia

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6084 ◽

2021 ◽

Vol 9 (B) ◽

pp. 318-325

Author(s):

Hatem Mohamed ◽

Anass M. Abbas ◽

Mohammed Ayed Huneif ◽

Seham M. Alqahtani ◽

Awad Mohamed Ahmed ◽

...

Keyword(s):

Blood Pressure ◽

Lipid Profile ◽

Density Lipoprotein ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Ramadan Fasting ◽

The Mean ◽

The Impact ◽

Type 2 Diabetic

BACKGROUND: Saudi Arabia is known to have one of the highest prevalence of diabetes in the world. The impact of Ramadan fasting on the health of type 2 diabetic patients is an important issue that has not been adequately investigated. AIM: The current study was aimed at assessing the impact of Ramadan fasting on hemoglobin A1C (HbA1c), lipid profile, blood pressure, and body mass index (BMI) in adult Saudis with Type 2 diabetes residing in Najran city. METHODS: This is a descriptive cross-sectional study which enrolled 289 patients who chose to fast during the month of Ramadan and were attending the outpatient clinics of Najran University Hospital. Fasting blood samples were taken 1 month before and 1 month after Ramadan to determine glycated hemoglobin and fasting lipid profile (low-density lipoprotein [LDL], high-density lipoprotein [HDL], triglyceride [TG], and total cholesterol [TC]) and BMI was also calculated. Information regarding demographics and physical activity was obtained through a questionnaire. RESULTS: As many as 176 (60.9%) of the participants reported to be physically inactive during Ramadan. There was a statistically significant (p < 0.05) decrease in the mean percentage of HbA1c when comparing before Ramadan (9.85 ± 2.37%) with after Ramadan (7.65 ± 1.70%). Furthermore, statistically significant difference (p < 0.05) was detected in the mean concentrations of LDL before (3.39 ± 1.06 mmol/L) and after (2.40 ± 0.83 mmol/L) Ramadan. The mean concentration of TC (before = 5.98 ± 2.00 mmol/L; after = 4.05 ± 1.18 mmol/L) and TG (before = 2.97 ± 1.95 mmol/L; after = 2.65 ± 1.65 mmol/L) also reduced after Ramadan. The mean concentrations of HDL (before = 1.78 ± 0.74 mmol/L; after= 2.23 ± 0.23 mmol/L) increased after Ramadan. The mean BMI of the study participants (before = 28.30 ± 6.27; after = 27.43 ± 5.92) decreased slightly after Ramadan. The systolic blood pressure (SBP) (before= 128.10 ± 6.32; after, 123.09 ± 5.71) and diastolic blood pressure (DBP) (before = 81.21 ± 8.51; after = 79.83 ± 7.21) showed a slight reduction after Ramadan. CONCLUSIONS: Type 2 diabetic patients who performed Ramadan fasting displayed a lowering of HbA1c, LDL, TC, and TG, and increased HDL, but had small positive effects on body weight, BMI, as well as SBP and DBP. More studies are needed with a larger population in the future to assess the potential of Ramadan fasting as a therapeutic strategy for managing Type 2 diabetes.

Download Full-text