The Effect of Ramadan Fasting on Anthropometric Measurements and some Biochemical Parameters among Type2 Diabetic Patients in Gaza Governorate

Abstract

Background: Ramadan is the ninth month of the Islamic calendar where all Muslims compulsory must abstain from daily eat, drink, smoke and sexual relations from dawn to dusk. This holy month provides a unique opportunity to evaluate its impact on different biochemical parameters and anthropometric measurements among type 2 diabetes mellitus (T2DM) patients. Objective: To assess the effect of Ramadan fasting on anthropometric measurements and some biochemical parameters among T2DM Patients in Gaza Governorate. Materials and Methods: This study is a cross sectional. The study was carried out in Ramadan (late of July to August, 2011) in Gaza Governorate when the length of fasting was 16 hours a day. A total of 80 T2DM patients, aged 40 to 65 years, without history of diabetes complication or other diseases were treated with the same oral hypoglycemic drugs (OHD), were compared with 40 healthy individuals used as a normal control. During one week before Ramadan (Visit-1) and one week before its end (Visit-2), Anthropometric evaluation and biochemical detection for serum fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), urea and creatinine were carried out. FBG, TC, TG, urea and creatinine were detected using ElITech clinical kit by chemistry autoanalyzer (BS- 120). HDL-C was determined by precipitation method using ElITech clinical kit. LDL-C was estimated from quantitative measurement of TC, TG and HDL-C using Friedewald formula. HbA1c was determined by chromatography method using GLOBE DIAGNOSTIC kit. Data analysis were analyzed using SPSS version 14 following the process of data collection by interview questionnaire. Results: There was statistically significant reduction in the mean of body weight (p=0.038 and p=0.000 respectively) and body mass index (BMI) (p=0.001 and p=0.000 respectively) at the end of Ramadan month among T2DM and controls as compared to pre-Ramadan. This study also found a statistically reduction in the mean ± SD of serum FBG during Ramadan as compared to values before Ramadan in both groups (p=0.000 and p=0.000 respectively). A statistically significant increase in the mean ± SD of serum TG levels was observed at the end of fasting among diabetic group (p-value=0.000) while, a decreased among control group which was not statistically significant (p-value=0.69) at the end of Ramadan fasting month compared to pre-Ramadan mean. A among diabetic group, the mean ± SD of HDL-C levels was showed significant reduction (P=0.000), while significant elevation in control group was observed (P=0.000) during Ramadan as compared to values before Ramadan. There was also statically significant elevation in the mean ± SD of serum TC (p-value=0.000 in both groups) and LDL-C (p-value=0.000 in both groups) during the period of fasting by comparison at the period before fasting. In addition, during the two experimental periods, there were no statistical differences in the mean ± SD of serum creatinine (p=0.0.193 and p=0.147 respectively) and urea levels (p=0.560 and p=0.143 respectively) in both groups. Concerning the HbA1c, the results also showed there were no statistical differences in the mean ± SD of HbA1c levels (p=0.133 and p=0.905 respectively) in both groups. Conclusions: Ramadan fasting is relatively safe and devoid of any serious complication among controlled diabetic patients. Furthermore patients should be properly educated about drug regimen adjustment, diet control, daily activities and possible complications that may suddenly occur and how to deal with them.