Transient increase in glucose variability during Ramadan fasting in patients with insulin-treated type 2 diabetes: A preliminary study

• Published in: Diabetes & metabolic syndrome clinical research & reviews Vol. 17; no. 4; p. 102745
• Main Authors: Elmalti, Akrem, Mukhtar, Mamoun, Kenz, Sami, Skaria, Sijomol, Elgzyri, Targ
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-04-2023
• Subjects: Blood Glucose; Blood Glucose Self-Monitoring; Clinical Medicine; Diabetes; Diabetes Mellitus, Type 2; Endocrinology and Diabetes; Endokrinologi och diabetes; Glucose; Glucose variability; Humans; Hypoglycemic Agents; Insulin; Islam; Klinisk medicin; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Ramadan; Glucose variability; Diabetes; Ramadan; Insulin
• ISSN: 1871-4021; 1878-0334
• DOI: 10.1016/j.dsx.2023.102745

We aimed to examine the effect of Ramadan fasting on interstitial glucose control and variability before, during, and after Ramadan in type 2 diabetes patients receiving insulin therapy.
Participants received a flash glucose monitoring (FGM) system one week before Ramadan that was removed on the sixth or seventh day (pre- and early Ramadan periods) of Ramadan and a second FGM system one week before the end of Ramadan that was removed one week after the end of Ramadan (late and post-Ramadan periods). Fasting blood samples were collected during the pre-, early, and late Ramadan study visits and tested for HbA1c, serum creatinine, and plasma glucose levels.
Thirty-four patients were prospectively included. The standard deviation and coefficient of variation of glucose concentrations were higher in the early Ramadan period than in the pre-Ramadan period, but did not differ in the late or post-Ramadan periods. Changes in the early Ramadan period were restricted to males and patients aged <55 years. No significant changes were observed in the average glucose level, glucose management indicator, time in range, time in hyperglycemia, or time in hypoglycemia at any time point.
Ramadan fasting in patients with insulin-treated type 2 diabetes is associated with an initial increase in glucose variability that quickly returned to pre-Ramadan levels. Ramadan fasting was not associated with any significant changes in glycemic control measures.
•The effect of Ramadan fasting on glucose control and variability in insulin-treated type 2 diabetes patients was examined.•Ramadan fasting caused an initial increase in glucose variability that quickly returned to pre-Ramadan levels.•Men and younger patients are at higher risk for this initial increased glucose variability.•Ramadan fasting did not cause significant changes in glycemic control measures in these patients.