METABOLIC AND CLINICAL EFFECTS OF ISLAMIC FASTING IN PATIENTS WITH TYPE 2 DIABETES MELLITUS.

Studies of the metabolic effects of Ramadan fasting on patients with type 2 diabetes mellitus are inconclusive.

Fifty-seven volunteers with type 2 diabetes underwent anthropometric and biochemical evaluation before and on the 14th and 28th days of Ramadan. Biochemical markers were measured by standard laboratory methods. Anthropometric measurements followed WHO criteria. Statistical analysis was by ANOVA for repeated measurements and Friedman's two-way ANOVA, using SPSSv6 software.

Daily cholesterol intake increased in all subjects (p<0.03). Body mass index increased (p<0.03) in women, but body mass index (BMI) and waist-to-hip ratio both decreased (p<0.01) in men. Blood pressure, fasting blood glucose and serum fructosamine did not change during the study. Plasma insulin (p<0.05), C-peptide (p<0.01) and insulin resistance (p<0.01) decreased only in men. Total and LDL cholesterol increased significantly in all subjects during the study.

Ramadan fasting does not alter carbohydrate metabolism or tissue insulin sensitivity in type 2 diabetes patients, given appropriate dietary education and rescheduling of oral hypoglycaemic medication. Lipid profile is unfavourably altered due to changes in both diet and biochemical response to starvation. Anthropometric indices improve in men but not women, possibly because of reduced physical activity in the latter.