Clinical and Metabolic Effects of Ramadan Fasting among A Sample of Diabetic Patients Attending Qualubeya Governorate Hospitals

Background: During Ramadan month Muslims neither eat or drink from down to sunset. Islam exempts some Muslims from fasting including diabetic patients. However, many diabetic patients insist on fasting without proper medical advice. Objectives: To determine the clinical effects of Ramadan fasting on diabetic patients, to identify the underlying factors of these effects and to outline recommendations for safe fasting. Method: This follow up study recruited 284 Muslim diabetic patients from two hospitals in Qualubeya Governorate, of these; only 200 patients completed the study. The patients were assessed by a structured questionnaire sheet, diabetes symptom checklist, anthropometric measurement and blood samples were collected to measure fasting blood glucose, cholesterol, triglyceride, High Density Lipoprotein, Low Density Lipoprotein and glycated hemoglobin (HbA1C). Results: There was a statistically significant increase in five DM symptom domain scores at the end of Ramadan than before; neuropathic pain, psychological fatigue, cardiovascular, psychological cognitive function and hyperglycemia P<0.05 for all). Anthropometric measurements (weight, BMI, waist-hip ratio), lipid profile and HbA1C were significantly (P<0.05) decreased at the end of Ramadan. Complicated DM during Ramadan fasting was related to physical inactivity, previous DM complications during Ramadan fasting, decreased food intake, increased fluid and sugar intake. Conclusion: Ramadan fasting is associated with DM complications in diabetic patients. So, management plans are recommended to minimize these complications.