There are no studies evaluating the glucose variability in different periods of Ramadan fasting in patients with type 2 diabetes using continuous glucose monitoring (CGM). This study examined the effect of Ramadan fasting on interstitial glucose (IG) variability in early,- late-, and post-Ramadan compared to pre-Ramadan days in non-insulin-treated type 2 diabetes patients. Participants had a CGM system connected 2 or 3 days before Ramadan start, which was removed on the third or fourth day of Ramadan. CGM performance continued for a total of 6 days. A second CGM performance started on the 27th or 28th day of Ramadan and ended on the 4th or 5th post-Ramadan day. First, CGM recordings were divided into pre-Ramadan and early-Ramadan CGM, and second recordings into late-Ramadan and post-Ramadan. At each visit, blood pressure, body weight, and waist circumference were measured, and fasting blood samples were collected for HbA1c and plasma glucose. All patients received recommended Ramadan education before Ramadan. Thirty-three patients (mean age 55.0 ± 9.8 years, 73% males) were prospectively included. IG variability, estimated as mean amplitude of glycaemic excursions (MAGE), increased significantly in early-Ramadan compared to pre-Ramadan (P = 0.006) but not in late-Ramadan and post-Ramadan recording days. Only patients on >2 anti-diabetic drugs (n = 16, P = 0.019) and those on sulphonylureas (n = 14, P = 0.003) showed significant increase in MAGE in early-Ramadan. No significant changes were seen in coefficient of variation, time in range, time in hyperglycaemia, or time in hypoglycaemia. Except for an initial increase in glucose variability, fasting Ramadan for patients with non-insulin-treated type 2 diabetes did not cause any significant changes in glucose variability or time in hypoglycaemia during CGM recording days compared to non-fasting pre-Ramadan period.

Aims: Delayed gastric emptying (GE) may have a major effect on the management of diabetic patients by causing upper gastrointestinal symptoms, impaired oral drug absorption and contributing to poor blood sugar control. Although the United Arab Emirates (UAE) has one of the highest prevalence of diabetes in the world, studies focusing on the prevalence of diabetes gastroparesis among these diabetics have never been reported previously. The aim of this study was to investigate gastroparesis among randomly selected Emirati type 1 and type 2 diabetic patients referred to a national diabetes center in the UAE. Methods: The study was designed as a controlled, single-blinded study. Using a standardized ultrasound technique, GE was studied in thirty-one randomly recruited type 1 and type 2 diabetic patients and ten normal healthy volunteers. The gastric emptying rate (GER) was estimated and expressed as the percentage reduction in antral cross-sectional area from 15 to 90 min after the ingestion of a semisolid breakfast meal. Results: In comparison to healthy volunteers, diabetic patients showed overall significantly wider mean values of the fasting as well as the postprandial antral areas. The mean value of GER in these Emirati diabetic patients was estimated at 17%, which was less than half of that in the healthy volunteers (50%). Statistically the difference was highly significant (p < 0.001). Normal gastric emptying was estimated as of GER > 32%. Consequently, 71% (22 of 31) of the diabetic patients in this study had more or less pronounced delays in GER (gastroparesis). Conclusions: The results from the present study indicate a higher prevalence of gastroparesis among randomly selected Emirati type 1 and type 2 diabetic patients, than in any other study previously published around the world. This is in line with previous reports about the high prevalence of diabetes complications among UAE diabetics. A larger study is needed to confirm these results.