The month of Ramadan, the 9 th month of the Islamic lunar calendar, is a holy month in the Muslim religion. During this period, Muslims must fast from dawn until sunset. The Holy Qur'an specifically exempts people with a medical reason from observing the fast, especially if this can have negative consequences on their health. [1] During the fasting, diabetic patients, because of their pathology, are exposed to an increased risk of hypoglycemia, loss of diabetes control, dehydration (especially in summer) and thromboembolic complications. Also, there are disturbances of chronobiology due to a change in the daily rhythm, marked by frequent disturbances in sleep, and a nocturnal diet. Because of all this, it is recommended for patients with T2DM who are uncontrolled, unstable, or have diabetes-related complications to avoid fasting. [1,2] Some patients proceed with fasting despite their physician's disagreement and the presence of a religious exemption. [1] We aimed to study the consequences of fasting and changes in eating habits on certain clinical and biological parameters in a group of diabetic patients compared to a control group and to derive some recommendations based on the results obtained. suBjEcts and MEthods Study designWe conducted an observational, descriptive and comparative study. We included 31 subjects divided into two groups: group 1 composed of 15 patients with T2DM, recruited from patients attending the National Institute of Nutrition in

(1) Background: Magnesium deficiency is usually associated with type 2 diabetes mellitus (T2DM). Individuals living with T2DM with hypomagnesemia show a more rapid disease progression and have an increased risk for diabetes complications. (2) Methods: This is a cross-sectional and descriptive study in the National Institute of Nutrition and Food Technology of Tunis in Tunisia, including all adult outpatients (≥18 years old) with a diagnosis of T2DM from 1 September 2018 to 31 August 2019. The aim of this study was to evaluate the prevalence of plasmatic magnesium deficiency in a Tunisian population of T2DM and to study the relationship between magnesium status and intake, glycemic control and long-term diabetes-related complications. (3) Results: Among the 101 T2DM outpatients, 13 (12.9%) presented with a plasmatic magnesium deficiency. The mean age was 56 ± 7.9 years with a female predominance (62%, n = 63). The mean of the plasmatic magnesium level was 0.79 ± 0.11 mmol/L (0.5–1.1), and the mean of 24 h urinary magnesium excretion was 87.8 ± 53.8 mg/24 h [4.8–486.2]. HbA1c was significantly higher in the plasmatic magnesium deficiency group than the normal magnesium status group (10% ± 1.3 vs. 8.3% ± 1.9; p = 0.04), with a significant difference in participants with a poor glycemic control (HbA1c > 7%) (100%, n = 13/13 vs. 53%, n = 47/88; p = 0.001). A weak negative relationship was also found between plasmatic magnesium and HbA1c (r = −0.2, p = 0.03). Peripheral artery disease was more commonly described in individuals with low plasmatic magnesium levels than in individuals with normal levels (39%, n = 5 vs. 0%, n = 0; p < 0.001). The mean plasmatic magnesium level in participants without diabetic nephropathy and also peripheral artery disease was significantly higher compared to individuals with each long-term diabetes-related complication (0.8 mmol/L ± 0.1 vs. 0.71 mmol/L ± 0.07; p = 0.006) and (0.8 mmol/L ± 0.1 vs. 0.6 mmol/L ± 0.08; p < 0.001), respectively. (4) Conclusions: Hypomagnesemia was identified in individuals with T2DM, causing poor glycemic control and contributing to the development and progression of diabetes-related microvascular and macrovascular complications.

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