Ramadan fasting in a sample Algerian population with diabetes

A considerable proportion of Muslims around the world are affected by diabetes. Ramadan fasting, a religious obligation for adult Muslims, is associated with increased risks of acute complications in patients with diabetes. In spite of these complications and an exemption provided by the Quran, many Muslims with diabetes, including a considerable number of Algerians, insist to fast. There is a scarcity of studies examining fasting patterns in Algerian people with diabetes.

To compare between fasting (≥1day) and non-fasting people with diabetes in terms of general characteristics and the frequency of acute complications during Ramadan in a sample Algerian population.

This cross-sectional study was undertaken in 2021 and included outpatients with T1DM or T2DM followed by Mustapha Bacha's university-hospital's diabetology's department, Algiers, Algeria. Data were collected using a purposely designed questionnaire and were analysed using SPSS ver.27.

458 participants were included, 53.1% female, 88.2% with T2DM, with a mean age of 59.8 (±13.55) years and a mean diabetes duration of 12.8 (±9.36) years. Participants fasted a mean 20.5 ± 13.53 days (T1DM: 6.3 ± 11.00; T2DM: 22.3 ± 12.72). A feeling of well-being and religious convictions were the dominant fasting decision-making factors in people with a high risk score. There was an increase in dietary and sugar intakes in 21.6% and 42.3% of the population respectively, a reduction in sleep duration in 34.5% and a lack of medical adjustment in the majority of participants. The risk score (IDF-DAR 2021) was significantly lower in the non-fasting group compared with the fasting group both in the general population and within the high risk category. No difference in the frequency of acute diabetes-related complications was found.

People with diabetes who fast during Ramadan tend to be younger, predominantly males and with a shorter diabetes duration compared with non-fasting people. The risk score (IDF&DAR 2021) remained significantly higher in non-fasting participants even when compared with fasting participants within the same high risk category. Acute diabetes-related complications do not appear to be more frequent in the fasting population. Access and adherence to pre-Ramadan diabetes self-management educations should be improved.