Evaluating the Effect of Ramadan Fasting on Muslim Patients with Diabetes in relation to Use of Medication and Lifestyle Patterns: A Prospective Study

Abstract

Objectives. This study aimed to examine the effect of Ramadan fasting on HbA1c in Muslim patients with type 2 diabetes. The incidence of hypoglycemia and glycemic changes in relation to the adjustment of doses of antidiabetic agents, diet, and physical activity during Ramadan was also evaluated. Methods. This was a prospective study conducted in an outpatient endocrine clinic. A set of questionnaires was administered to Muslim patients with diabetes who fasted for ≥10 days. Those who were hospitalized for diabetic ketoacidosis or severe hypoglycemia a month prior to Ramadan or were given short-term corticosteroid therapy were excluded. The patients' responses and clinical outcomes from the clinic database were collected before, during, and after Ramadan. Results. A total of 153 participants completed the study. The mean HbA1c improved from 8.9% before Ramadan to 8.6% during Ramadan (P < 0.05). Although diet and physical activity did not contribute to changes in glycemia, a significant improvement in HbA1c was observed in patients who had adjustments made to their doses of antidiabetic agents during Ramadan (P < 0.001). In addition, their rate of hypoglycemia was minimal. Conclusions. Ramadan fasting appeared to improve glycemic control, especially in those whose doses of antidiabetic agents were adjusted during Ramadan.

Primary Care Providers’ Knowledge and Practices of Diabetes Management During Ramadan

“…12,13 Other studies have shown improved overall glycemic control among patients with diabetes who fast during Ramadan who actively have their diabetes medications adjusted. 14,15 This study shows that for a large inner-city primary care clinic in the United States that serves a multiethnic population, there are areas for improvement to increase awareness, education, and provider comfort in caring for Muslim patients with diabetes who fast during Ramadan. Many of our health care providers had variable knowledge regarding Ramadan, did not follow American Diabetes Association guidelines, and most felt uncomfortable in their management of diabetes during Ramadan.…”

The characteristics and pattern of care for the type 2 diabetes mellitus population in the MENA region during Ramadan: An international prospective study (DAR-MENA T2DM)

“…By the nature of their study design, retrospective studies often lack baseline data either due to a lack of recording or as a result of being dependent on patient recall. Although some prospective studies have been performed, they generally lack pre-Ramadan data for some or all parameters and are relatively small-scale [18][19][20]. Large-scale, prospective studies with detailed collection and analysis of fasting parameters as well as glycemic, biochemical and biometric measures during and prior to Ramadan are, therefore, required in order to provide greater understanding of treatment requirements for individuals who choose to fast during Ramadan.…”

Effect of Ramadan fasting on glucose level, lipid profile, HbA1c and uric acid among medical students in Karachi, Pakistan

“…Many studies have been conducted on the effects of fasting, the majority of which are related to patients who have diabetes and management of their disease (3)(4)(5)(6)(7)(8)(9)(10). However, other studies have been conducted on non-diabetes patients and healthy subjects (11)(12)(13)(14)(15)(16).…”