The Effect of Fasting Ramadan on Diabetic Patients with High Risk of Cardiovascular Disease

One of the common questions for patients with a history of cardiovascular disease is whether it is safe for them to fast during Ramadan. Yet, studies on the effects of Ramadan fasting on blood lipids, blood pressure, anthropometric parameters and other cardiovascular risk factors are scarce, and have given inconclusive results. The aim of this study is to investigate the effect of Ramadan fasting on cardiovascular risk factors including biochemical indices, blood pressure and main anthropometric parameters. This Prospective observational study was conducted at the CCU (Coronary care unit) and medical wards of Madinat Zayed hospital one of Al Dhafra hospitals, under Seha Abu Dhabi. Fifty-Six diabetic patients admitted with cardiovascular events including 48 males and 8 females with a previous history of cardiovascular event completed the study. Their age ranged between 32 and 91 years with a mean of 54.0 ± 10 years. A non-significant slight biochemical modification with regard to the metabolic profile pre, during and post-Ramadan period was reported: eGFR, total cholesterol, LDL, and HDL were increased yet, triglycerides and creatinine were non-significantly lower during Ramadan. Findings also showed a non-significant decrease in the post Ramadan blood pressure values which could be attributed to the metabolic switch.

Impact of Fasting during Ramadan on Daily Habits, Diet and Body Weight of individuals with diabetes: A sample of Saudi Arabia

@#Introduction: Many changes occur in Muslims’ lives during Ramadan that affect body weight, diet and calorie intake. This study investigated the impacts of fasting during Ramadan on the daily habits, diet, and weight of people with diabetes in Saudi Arabia. Methods: A cohort study analyzed 104 Saudi individuals with diabetes (42 and 62 patients with type I and type II diabetes, respectively) aged ≥ 20 years who fasted a minimum of 15 days during Ramadan. The patients were seen twice per study period (before and during Ramadan). The patients’ demographic data was obtained, their average daily food intake was assessed, and anthropometric parameters were measured. Results: During Ramadan, 52% of patients with type I DM and 66% of patients with type II DM did not perform any physical activity compared to 37% and 42%, respectively, pre-Ramadan. A high percentage of patients slept during the daytime. A paired-sample T test analysis showed that during Ramadan, the calorie intake and carbohydrate intake increased significantly in patients with type II diabetes (p = 0.03). Protein intake remained unchanged, whereas fat consumption increased in patients with both types of diabetes (p = 0.03 and 0.04, respectively). In addition, there was a decrease in anthropometric parameters (statistically significant in patients with type II diabetes, p < 0.05). Conclusion: Ramadan fasting changed the dietary and daily habits of patients with diabetes in Saudi Arabia and had beneficial effects on weight, mainly in patients with type II DM.

Glycaemic changes among children and adolescents with Type 1 Diabetes Mellitus before and during Ramadan fasting using continuous glucose monitoring / Journal of the ASEAN Federation of Endocrine Societies

Objectives@#This study described and compared glycaemic changes with the use of the following Continuous Glucose Monitoring (CGM) metrics: time in range, time in hyperglycaemia and time in hypoglycaemia from retrospective CGM data among children and adolescents with Type 1 Diabetes Mellitus (T1DM), before and during Ramadan to better understand the impact of fasting during this season. @*Methodology@#This study was conducted in 2 tertiary centres: Hospital Putrajaya (HPJ) and Hospital Universiti Sains Malaysia (HUSM) from February to May 2020. Muslim T1DM patients between ages 8 to18 who intended to fast during Ramadan were given Ramadan-focused education. CGM iPro2® (Medtronic) was used before and during Ramadan, complemented by finger-prick glucose monitoring or self-monitoring of blood glucose (SMBG). @*Results@#Of the 32 patients, only 24 (12 female) were analysed. Mean age was 13.6 ± 3.1 years old, mean HbAlc was 9.6 ± 1.9% and mean duration of illness was 5.4 ± 3.4 years. Majority (91.7%) were on multiple dose injections (MDI) while only 8.3% were on continuous subcutaneous insulin infusion (CSII). All fasted in Ramadan without acute complications. Retrospective CGM analysis revealed similar results in time in range (TIR), time in hyperglycaemia and time in hypoglycaemia before and during Ramadan, indicating no increased hypoglycaemic or hyperglycaemic events related to fasting. Glycaemic variability before Ramadan as measured by the LBGI, HBGI and MAG, were similar to values during Ramadan.@*Conclusion@#Ramadan fasting among T1DM children and adolescents, by itself, is not associated with short-term glycaemic deterioration. T1DM youths can fast safely in Ramadan with the provision of focused education and regular SMBG.

Ramadan fasting during pregnancy: characteristics and outcomes

Background: The primary aim of this study was to measure the prevalence of pregnant women who fast during Ramadan. The secondary outcome was their beliefs and motivations regarding fasting during Ramadan in addition to the consequences of fasting on maternal and neonatal outcome.Methods: A retrospective review of pregnant patients aged between 18-45 years who presented for antenatal care in the private clinic in Beirut, Lebanon during or after the month of Ramadan between 2010 and 2019 was performed.Results: A total of 502 pregnant patients were included in the study, of which 426 (84.9%) fasted during Ramadan and 76 (15.1%) did not fast at all. Of those who fasted, 148 (34.7%) fasted between 1 and 15 days while 278 (65.3%) fasted more than 15 days. Multiparous and non-Lebanese women had significantly higher rate of fasting compared to primiparous and Lebanese women. Adherence to fasting was associated with the spiritual environment that accompanies the month of Ramadan while non-adherence was mainly related to the fear from adverse effects on the mother and fetus. Fasting was not significantly associated with maternal complications or decreased neonatal birth weight.Conclusions: The present study showed that Ramadan fasting is important to pregnant Muslim women. This was manifested by the relatively high rate of fasting even in summer and spring seasons. Understanding the beliefs and motivations of pregnant women would provide valuable insight to physicians to appropriately advise these women without compromising the maternal or fetal well-being.

Hemodynamic Variations Associated with Ramadan Fasting among Saudi Stroke’s Patients

Background: It was reported that intermittent fasting has several health benefits. Therefore, the present study aimed to assess the hemodynamic variations associated with Ramadan fasting among Saudi Stroke patients. Methodology: Information referring to 61 stroke patients were retrospectively retrieved from King Khalid hospital, Hail, Northern Saudi Arabia. Data relating to patients attended during the period from April 2019 to June 2019. The sample involved two months (Shaban and Ramadan) a full coverage sample. Results: Out of 61 study subjects, 26 patients were fasting during stroke happening and 35 patients were non-fasting. Out of the 61 patients, 35 (57.4%) were females and 26 (42.6%) were males. With the fasting month, hypertension was co-occurrence in 23/49 (47%) fasting patients, hence, it occurred in 26/49 (53%) among non-fasting patients, the risk of hypertension during Ramadan compared to nonfasting month; the relative risk (RR) and 95% confidence interval (95% CI): RR (95%CI)=1.1908 (0.9374 to 1.5128). Conclusion: Ramadan Fasting has some beneficial effects influencing stroke including incidence and severity reduction. Stroke associated hemodynamic variants, which were more apparent among women, were perceived to decline during fasting.

Knowledge, attitude and practices of Ramadan fasting on health and disease among pregnant Muslim women in urban health centre of a medical college

Background: Fasting during the holy month of Ramadan entails abstinence from food, water, smoking and drugs from dawn to sunset. In Islamic religious rule fasting during Ramadan is not mandatory if there is any contraindication such as illness, old age, pregnancy, etc. Many studies have shown that most Muslim women choose to fast during pregnancy because of a sense of religious duty, familial support, positive views on fasting and difficulty in completing the missed fasts at another time.Methods: A cross sectional study was conducted on 124 pregnant Muslim women attending urban health centre for antenatal care during the month of Ramadan at Davanagere city. Data was entered in the Microsoft Excel and presented in the form of frequencies.Results: In this study majority of pregnant women believed that fasting during pregnancy is harmful to mother as well as child. Overall, 80.6% of pregnant women did not observed fasting during pregnancy.Conclusions: In this study majority of the pregnant women did not observed fasting during the month of Ramadan. Health education should be given to all pregnant women and family members regarding adverse effect of fasting on mother and child health.

Effect of Ramadan fasting on glycaemic parameters & body mass index in type II diabetic patients: A meta-analysis

Background & objectives: There has been an ongoing debate about the impact of Ramadan fasting (RF) on the health of these individuals who fast during Ramadan. The aim of this meta-analysis was to evaluate the relationship between RF and glycaemic parameters in type 2 diabetes mellitus (T2DM) patients. Methods: Search terms were decided and databases such as MEDLINE EBSCO, Google Scholar and EMBASE were searched for eligible studies. Standardized mean differences and 95 per cent confidence intervals (CIs) of post-prandial plasma glucose (PPG), fasting plasma glucose (FPG), glycated haemoglobin (HbA1c) (%) and fructosamine levels were calculated for different treatment regimens. Results: Of the 40 studies, 19 were found eligible for inclusion in the meta-analysis. Based on pooled results, significant reductions in FPG were found in single oral antidiabetics (OAD) [standardized weighted mean difference (SMD)=0.47, 95% CI=(0.20-0.74)], multi-OAD [SMD=0.36, 95% CI=(0.11-0.61)] and multitreatment subgroups [SMD=0.65, 95% CI=(0.03-1.27)] and overall [SMD=0.48, 95% CI=(0.27-0.70)]. Furthermore, HbA1c(%) [SMD=0.26, 95% CI=(0.03-0.49)] and body mass index (BMI) [SMD=0.18, 95% CI=(0.04-0.31)] were significantly decreased in the multi-OAD group. Interpretation & conclusions: The meta-analysis showed that RF was not associated with any significant negative effects on PPG and fructosamine levels. However, BMI and FPG and HbA1c(%) were positively affected by RF.

Efectos del ayuno en sujetos que realizan el ramadan sobre la calidad de vida y su relación con la diabetes y la hipertensión / Fasting's effects on people in ramadan about their quality of life and the relationship with diabetes and hypertension

El precepto islámico del Ramadán (R), impone a las personas que lo practican importantes modificaciones fisiológicas debido a las restricciones hídricas y dietéticas a lo largo del día y durante un mes, lo que tiene una especial repercusión física e intelectual de los musulmanes. El objetivo del presente estudio es describir los efectos del ayuno del Ramadán en la calidad de vida, así como, su repercusión en la Diabetes e Hipertensión. Participaron un total de 44 sujetos, 22 hombres y 22 mujeres. Con edades comprendidas entre los 14-80 años residentes en Tetuán y Ceuta. En un diseño de grupo único, creando subgrupos en función del sexo o patología. Las mediciones principales son las 8 escalas que miden los 36 items del cuestionario SF-36. Durante el R se evidencia en hombres y mujeres un mayor deterioro de la función física, siendo también significativa una disminución de la percepción de salud mental en el sexo masculino. En las personas diabéticas la percepción de disminución de la calidad de vida es mayor en relación a los parámetros físicos, así como en la salud mental y salud en general. Los sujetos hipertensos presentaron de forma significativa peores valores en los ítems de salud física y mental. El mes de R, en el conjunto de la población, provoca una menor percepción de la calidad de vida, más pronunciada en el caso de las mujeres. En concreto, los diabéticos y los hipertensos, estudiados, perciben una menor calidad de vida que en condiciones normales en cuanto a función física y rol físico se refiere(AU)

The Islamic precept of Ramadan (R) imposes on individuals who practice it important physiological modifications due to the hydric and dietetic restrictions along a whole month plus a day, all of which have a crucial repercussion over the physical and intellectual performance of Muslim. The objective of this study was todescribe the effects of fasting during R in quality of life and its relationship with pathologies such as diabetes and hypertension. It took part 44 individuals, 22 men and 22 women with an age among 14 and 80 year old, from Tetuan and Ceuta. A model in only one group, making sub-models according to sex and pathology. The main measuring are the eight scales that measure 36 items in the SF-36 survey. During R we can see worst results in both men and women in relation with physical function. We can also observe a decrease in the perception of mental health in male sex the perception is even higher in diabetic people in relation to physical parameters, as in mental health in general. Worst values show individuals suffering of hypertension in their perception of physical and mental health.This month of R in the population as a whole causes a less perception in quality of life which is even worst in the case of women. Being concrete, diabetic and hypertension people receive a less quality of life than in normal conditions talking about physical role and function(AU)

Time Course Of Cigarette Withdrawal Symptoms While Using Nicotine Patch During Ramadan / Jurnal Sains Kesihatan Malaysia

Previous studies explain the time course of withdrawal symptoms among smokers pre and post quit attempt, either withor without the help of medication. Studies showed that male Muslim smokers could quit smoking during Ramadan sincefasting relate to the changes in psychosomatic, daily activities and nicotine withdrawal symptoms. This study aimed toinvestigate the time course of withdrawal symptoms among smokers who used nicotine patch to quit smoking duringfasting in Ramadan. A total of 40 eligible Muslim males who tried to quit smoking was selected and provided with smokingcessation counseling for the duration of 8 to 10 weeks while on nicotine patch. Participants level of withdrawal symptomswas recorded by using nine items of Minnesota Nicotine Withdrawal Scale over a period of 60 days. Participant’s carbonmonoxide reading and body weight were measured within six months including pre and post-Ramadan fasting. Over fourweeks of the fasting month, the measured withdrawal symptoms such as urge to smoke (P ≤ 0.001), depressed mood (P≤ 0.001), irritability/frustration or anger (P ≤ 0.05), anxiety (P ≤ 0.05), difficulty concentrating(P ≤ 0.001), restlessness(P ≤ 0.001), difficulty going to sleep (P ≤ 0.001) and impatient (P ≤ 0.05) significantly decreased except appetite by theend of week 4. Time course analyses demonstrated that all outcome measures showed good effects during cessation infasting month. The point prevalence abstinence at first month of quitting was 67.5% which is higher in fasting month.This has shown positive clinical implications in managing smoking cessation program during Ramadan with the aid ofnicotine patch.

Predetermined Anti-Diabetic Drug Regimen Adjustments during Ramadan Fasting: An Observational Study of Safety

BACKGROUND: Many Muslim type 2 diabetes mellitus (T2DM) patients choose to fast the month of Ramadan despite the possible adverse health effects brought about by the change in dietary habits, among other things. Clinical data regarding the safety of multi-drug regimens during fasting are particularly scarce. The aim of the study was to evaluate the safety of a drug protocol devised by the authors to accommodate Ramadan's dietary changes, involving dose adjustments of four anti-diabetic drug regimens in T2DM patients fasting Ramadan. METHODS: In this prospective, observational, open-label study, 301 T2DM patients who wished to fast Ramadan were followed during Ramadan and the preceding month. The incidence of hypoglycemia, diabetic ketoacidosis (DKA) and non-ketotic hyperosmolar state (NKHS) was monitored. Patients were classified into four groups: A group (those taking metformin, sulfonylurea and insulin [n=33]); B group (metformin and sulfonylurea [n=89]); C group (metformin and insulin [n=96]); and D group (premixed 70/30, glargine or regular insulin [n=82]). During Ramadan, drug doses were adjusted as percentages of their pre-Ramadan values: 75% for sulfonylureas, 75% for glargine, 75% for premixed insulin 70/30 in two doses, and 75% for regular insulin. Metformin was adjusted to a twice-daily regimen. RESULTS: No cases of DKA or NKHS were reported. Hypoglycemia occurred at a lower rate than pre-Ramadan values in groups C, and D; and a similar rate in groups A, and B. CONCLUSION: The data suggested that using the above protocol to adjust the doses of anti-diabetic drugs is safe in T2DM patients in regards to hypoglycemia, DKA, and NKHS.

The Impact Of Ramazan I’tikaf On Immune System

@#I'tikaaf is a worship maintained by very deep hunger in fasting month of Ramadan. Hunger causes different results on the immune system. This is a prospective study. In this study, the changes in the immune system were investigated during the period of the i’tikaf, which is deep hunger worship. In the last 10 days of Ramadan, before and at the end of i’tikaf blood was taken from 46 male volunteers who performed i’tikaf worship and various biochemical and immunological parameters were examined. Comparison of the measures taken before and after i’tikaf indicated a statistically significant decrease in weight, BMI, waist circumference and hip circumference (p<0.001). Of the hematologic parameters, the lymphocyte count increased significantly (p=0.009). Also, a significant increase was observed in the values of IgA, IgM ve Ig G within the hematological parameters (p<0.001). During the period of i’tikaf, feeding with very low calories (1000 calories) caused an increase in the levels of lymphocyte and immunoglobulins and got the immune system stronger.

The clinic features of upper gastrointestinal bleeding among Hui-Nation patients admitted hospital on Ramadan / 中华急诊医学杂志

Objective The aim of this study was to analyze the characteristics of upper gastrointestinal bleeding (UGIB) admitted on Ramadan or no-Ramadan.Methods We analyzed HuiNation patients' admissions of UGIB in Ningxia Medical University General Hospital from 2000 to 2013 (a total of 1192 admissions).Differences in etiological,transfusion undergo early esophagogastroduodenoscopy (EGD) and hospital stays between Hui-Nation patients on Ramadan.Results Ramadan admissions were associated with significantly higher hemorrhage rates than no-Ramadan admissions among Hui-Nation patients.Peptic ulcer (56％),esophageal varices (17％) and gastric erosive (12％) were the main reason of UGIB in Ramadan.Ramadan admissions were associated with significantly blood transfusion,less likely to undergo early EGD,mortality and long length of stay (p ＜ 0.05).Conclusions Ramadan admission of UGIH was higher than no-Ramadan.Doctor should pay more attention to this phenomenon.

Pregnancy and Ramadhan Fasting.

Fasting during the month of Ramadan is a religious obligation for healthy adult Muslims. Pregnant and lactating mothers are exempt from fasting but they do fast during the month of Ramadan. Numerous metabolic, endocrinal changes and adaptations occur in pregnancy. The long hours of abstinence of food and liquids during pregnancy may affect the intrauterine environment. There are reports of undesirable and harmful effects of fasting on the mother and the foetus, whereas others do not report any such significant adverse effects. The conflicting reports confuse the pregnant mothers and the caring practitioners. The object of this article is to critically analyse the outcome of pregnancy due to Ramadan fasting and whether the Ramadan fasting adversely affect the mother and her foetus.

Effect of Ramadan Fasting on Anthropometric Measures and Metabolic Profiles among Type 2 Diabetic Subjects.

Background: Fasting from dawn to dusk during the month of Holy Ramadan is obligatory for all healthy adult Muslims. Individuals are exempted from fasting if they are suffering from an illness that could be adversely affected by fasting. Although The Quran exempts sick people from fasting, many Muslim diabetic patients may not perceive themselves as sick and are keenly interested to fast. But they fast without proper medical guidance exposing themselves to certain risks as a direct consequence of fasting. So we designed this study to assess the impact of fasting during Ramadan and to evaluate the effects of fasting on their biochemical profiles in patients with diabetes. Objective: The objective of this study was to investigate whether Ramadan fasting has any effect on body weight, blood pressure, fasting glucose, HbA1C, serum lipids, serum creatinine among type 2 diabetic patients. Materials and Methods: Fifty two stable outpatients with type 2 diabetes with intention to fast were studied in the month of Ramadan 1434 Hijri calendar year (11th July to 9th August, 2013) at two points of time: one week before Ramadan (visit 1) and within last 3 days before the end of Ramadan (visit 2). During each visit the height, body weight and blood pressure were recorded. Blood samples were collected for fasting glucose, HbA1C, total cholesterol, triglyceride, high density and low density lipoprotein cholesterol and creatinine. Data were analyzed by Student’s paired t-test using SPSS system and results were expressed as mean ± SD. Probability values were considered to be significant if it was less than 0.05. Results: There were 30 (62.8%) males and 22 (37.2%) females with a mean age of 54.7 ± 11.55 (range 35–80) years and mean duration of diabetes was 5.5 ± 5.2 years (range 9 months–18 years). In this study mean weight of the patients decreased significantly from 60.5 ± 12.6 kg to 58.5 ± 11.3 kg (p<0.001). Blood pressure reduced but not significantly. Fasting blood glucose showed significant reduction from 10.7 ± 4.2 to 8.9 ± 3.7 mmol/L (p=0.002) at the end of the study though HbA1C showed no significant change. Lipid profile and serum creatinine values did not show any significant change. Conclusion: The effects of fasting during Ramadan on stable diabetic patients are minimal. So, stable diabetic patients can fast during Ramadan without significant detrimental effects.

Ramadan Fasting and Maternal Perspectives in Healthy Pregnant Women: Systematic Review.

Background: Practicing fasting during Ramadan by pregnant women might be risky. Controversies still exist about the nature and the magnitude of metabolic changes in healthy pregnant women who practice fasting. Objectives: To systematically review literature pertaining to the practice of Ramadan fasting and the effect of fasting on maternal health. Methods: Relevant literature was obtained through searches of PubMed, and Cochran's. Incidence and duration of fasting, reasons for non-fasting, dietary changes, physical activity, weight changes, symptoms with fasting, and metabolic parameters for healthy pregnant women who fasted during Ramadan were extracted. Synthesis of data was performed when appropriate. Results: Out of 56 English-language studies, 21 addressed maternal perspectives, 85.57% women experienced fasting during pregnancy, 76.26% fasted the whole month or ≥20 days, 80.9% perceived fasting as obligatory, 63.1% perceived no harm in fasting during pregnancy, and 17.6% broke their fast because of harm. The reasons for non- fasting included pregnancy (25%), coexisting medical problems (20.6%), symptoms (16.2%), daily commitments (16.2%), personal, family reasons (13.2%), and belief that fasting is not compulsory (8.8%). Common symptoms were hunger or thirst (16.82%), nausea or vomiting (7.47%), giddiness (6.66%), fatigue (17.01%), and fever or headache (2.72%). Accelerated starvation was reported in many studies; whereas hyperglycemia was reported in only 2 studies. Negative impact of fasting on lipids and hormones was reported in a few studies. Conclusion: There are large gaps in knowledge, and more large interventional clinical trials are needed. In the light of available research, the majority of pregnant women showed a strong sense of religious obligation and chose to fast, even though some of them did not fully recognize their right to be exempted. There is still no definite evidence that accelerated starvation due to Ramadan fasting during an uncomplicated pregnancy can adversely affect maternal health.

Update on the Management of Diabetes during Ramadan Fast for Healthcare Practitioners

Fasting during the month of Ramadan is one of the five pillars of Islam, a recurring annual ritual, which is passionately practiced by most Muslims across the world. It is obligatory on every healthy Muslim; however, the Qur’an and Islamic teachings specifically exempt people with acute or chronic illnesses from this duty, especially if it might have harmful consequences. Muslims with diabetes are exempted from fasting, but many of them still fast during Ramadan, for their personal convictions as revealed by EPIDIAR study which showed that 43% of patients with type 1 diabetes and 79% with type 2 diabetes fasted during Ramadan. Muslims constitute about a quarter of the world’s population who are spread all over the globe. It is inevitable that health care issues peculiar to them will be encountered worldwide and health care providers will have to counsel them regarding medications and whether it is safe to undertake the fast. This paper is an update on the management of Ramadan fasting based on current evidence from published literature and expert opinions.

The Effectiveness of Ramadan Focused Education on Awareness and Glycemic Control of Diabetic Muslims (Type 2 Diabetes) During Ramadan Fasting

The majority of Muslim diabetic patients are unaware of complications during fasting, therefore diabetic patients who want to fast need a pre–Ramadan assessment and education to increase their awareness of the risks of fasting. This study examined the effectiveness of Ramadan focused education aimed at increasingself-awareness and glycemic control in Muslims with type 2 diabetes who fast during Ramadan. A pre and post experiment with a randomized controlled trail was being conducted among 212 patients at Primary Care Units of Songkhla. To be eligible, patient participants must be fasting diabetic patients during Ramadan.The study is a two-centre randomized wait-list controlled trial. Subjects were 108 patients who were allocated to the intervention group (educated about meal planning, physical activity, medications, recognizing and managing complications before Ramadan) and 104 patients were in the control group or wait list control (The control group received conventional group counseling).The data were analyzed using descriptive statistics, ANCOVA, and t- test. After Ramadan, we observed no difference in FBS and HbA1c between intervention and control patients. On comparing the self-awareness score of realization of the diabetic patients between the intervention and the control groups after adjusting for baseline [adjusted difference1.10, 95% confidence interval (CI). 29, 1.71; P=0.005], the difference statistically significant (p< 0.005). The intervention significantly increased self-awareness. The role of structured education for patients is well established in the management of diabetes. This should be extended to Ramadan-focused diabetes education and drug modification program on awareness of self-care and glycemic control in Muslims with type 2 diabetes who fast during Ramadan in Thailand.

Effect of Ramadan Fasting on Serum Lipid Profile of Bangladeshi Female Volunteers.

The study was conducted to evaluate the effects of fasting for a period of one month during Ramadan on the lipid profile of Bangladeshi female volunteers who fasted during the Arabic month of Ramadan, when there occurs a change, both in the pattern and timing of dietary intake. Findings of the study showed that Ramadan fast significantly reduced serum Total cholesterol (TC) (p=0.030) and Low density lipoprotein (LDL-C) (p=0.011). A statistically nonsignificant elevation of triglyceride (TG)) was observed (p=0.598). High density lipoprotein cholesterol (HDL-C) also found to be raised significantly at the end of fasting (p = 0.037). Findings of the study revealed that fasting during the month of Ramadan changes lipid profile pattern in an aniatherogenic direction and may be beneficial to health.

Ajustes endocrino-metabólicos durante el ayuno de Ramadán en jóvenes deportistas / Endocrine-metabolic adjustments during Ramadan fasting in young athletes

El precepto islámico del Ramadán (R), implica importantes modificaciones fisiológicas debido a las restricciones hídricas y dietéticas a lo largo del día y durante un mes, lo que tiene una especial repercusión física e intelectual de los musulmanes, particularmente en sociedades occidentales, en las que no se producen reajustes horarios para las actividades cotidianas. Entre las modificaciones impuestas por el R, el ayuno intermitente día/noche, desencadena mecanismos de adaptación para rentabilizar el consumo energético. El objetivo del presente estudio ha sido valorar algunos cambios endocrinometabólicos que acontecen a lo largo de la jornada, durante el mes de ayuno, en jóvenes que tienen que continuar con su actividad y entrenamiento deportivo habitual. Diez jóvenes musulmanes, varones, sanos, sometidos a entrenamiento deportivo, con edades entre 18 y 25 años que realizaron el R. Se analizaron parámetros bioquímicos y hormonales en plasma, una semana previa al R, primera y cuarta del periodo de ayuno (mañana y tarde) y semana posterior. Durante el R, se observa un descenso de los parámetros bioquímicos a lo largo del día, especialmente de la glucemia, siendo estos cambios más evidentes en la primera semana. La concentración de cortisol se encuentran significativamente elevada durante todo el mes, como consecuencia del cambio de ritmo circadiano de secreción. El R obliga al organismo a un ajuste endocrino-metabólico con el fin de preservar la eficiencia energética durante la jornada. Este control se vuelve más eficaz conforme avanza el mes de ayuno y la consecuente adaptación fisiológica.

The Islamic precept of R implies important physiological modifications due to the hydric and dietetic restrictions along a whole month plus a day, all of which have a crucial repercussion over the physical and intellectual performance of Muslims, particularly in occidental societies, in which there is no hour readjustments for daily activities. Among the imposed modifications by Ramadan in daily habits, intermittent fasting along day and night causes adaptation mechanisms to optimize the energy consumption. The objective of this study was to analyze the metabolic-endocrine changes that happen during daily working hours, along the month of fasting in young subjects who have to continue their usual activities and sport training. Ten young muslim subjects, male, healthy, set to sport training, ages in between 18 and 25 who completed Ramadan. Plasma biochemical and hormonal parameters were analyzed in plasma, a week before Ramadan, in the first and fourth of the fasting month and a week after conclusion. During Ramadan, have been observed a drop of biochemical parameters along daytime, especially those related to glycemia, being these changes stronger in the first week. The concentration of cortisol found to be significantly high during the whole month as a consequence of adaptation to the change of circadian secretion rhythms. Ramadan obliges subject´s organisms to readjust their endocrine and metabolic system in order to preserve the energetic efficiency during daytime. This auto control becomes more efficient as long as the month advances due to physiological adaptations.

Diabetic patients and ramadan / Journal of the ASEAN Federation of Endocrine Societies

@#More than 50 million people with diabetes mellitus fast during Ramadan, a religious obligation for all healthy adult Muslims. Fasting leads to several physiological changes in the body and these may result in acute complications in persons with uncontrolled diabetes such as hyperglycemia, hypoglycemia, diabetic ketoacidosis, dehydration and thrombosis. Evidence from existing literature guides the physicians in their assessment of Muslim patients with diabetes who wish to fast. Assessment should include risk stratification based on existing control of diabetes and its chronic complications. In the light of this assessment medical recommendation is given which includes dose modification of oral medication and insulin, dietary advice and structured patient education.