Follow-up of glycemic index before and after Ramadan fasting in type 2 diabetes patients under antidiabetic...

Fasting has no adverse effects on healthy Muslims during Ramadan. However, it can induce serious complications for patients with type 2 diabetes (T2D). We aimed to follow the variation of some biochemical and clinical parameters in T2D patients before and after Ramadan; and to determine the incidence of fasting on hypoglycaemia and lactic acidosis associated with antidiabetic agents such as metformin.

This work is a prospective study conducted during Ramadan on 150 patients, recruited 2 to 3 weeks prior to the start. These patients were sensitized about the Ramadan lifestyle and diet as well as the medications to take.

This study results indicated a significant decrease of glycated haemoglobin (from 8.06% to 7.42%) and a similar trend in the fasting plasma glucose (from 1.81 to 1.36g/L) before and after Ramadan respectively. The serum lipid profile showed significant variations during the study period, and antidiabetic medications was associated with low serum lactate. The plasma creatinine and uric acid were reduced but remained insignificant.

Based on data from our study, we concluded that a safe fasting with a lower risk hypoglycaemia, can be achieved in a well-controlled patients, under antidiabetic drugs. However, the diabetes medication was associated with a small increase in serum lactate levels that seemed to be dose-independent and not affected by treatment duration.