Endocrine Abstracts

Introduction: Several studies have been conducted to study the effect of fasting on the clinical and metabolic parameters of patients with multiple cardiovascular risk factors, particularly diabetes, hypertension, and dyslipidemia. Our aim was to study the effect of Ramadan fasting on the clinical and metabolic parameters of a previously educated population of diabetic, hypertensive and dyslipidemic patients.

Methods: This is a prospective study that involved 140 patients who wish to fast the month of Ramadan (2016) and who have presented themselves at the consultations dedicated to preparing diabetic patients wishing to fast, organized at The National Institute of Nutrition of Tunis (departement C). Patients were given an interview, a thorough clinical examination and a biological assessment and were well informed about the risks they face.They had the appropriate therapeutic adaptation (ADA recommndations of 2010), as well as an adequate hygiene and dietary education. We have totally banned fasting for unbalanced patients.

Results: 38 were diabetics (all type 2), hypertensive and dyslipidemic. The average number of days fasted was 21±4.54 days. The sex ratio was 0.31. The average age was 58.7±8.48 years. Diabetes has evolved since 9.5±6.38 years on average, poorly balanced in 71% of cases. 23.68% of cases were insulin-dependent. The body mass index was 30.64±5.67 kg/m². The average weight was 80.63±14.45 kg. Hypertension has evolved since 6.46±4.7 years on average and dyslipidemia since 3.77±3.37 years. The mean fasting glucose level was 9.11±3.45 mmol/L. The mean HbA1C was 8.19±1.54%. The mean systolic and diastolic arterial pressures were 13.05±1.52 and 7.46±0.93 mm Hg, respectively. Mean cholesterol, triglyceride, HDL and LDL were 4.45±0.98, 1.49±0.74±0.1±0.25 and 1.05±0.37 mmol/L, respectively. 3 cases of moderate hypoglycemia and 3 cases of hyperglycemia greater than 3 g/L were reported during the fast. After fasting, the average weight was 80.55±15.46 kg. The average fasting glucose level was 8.65±2.96 mmol/L. Mean HbA1C remained stable at 8.18%. Systolic and diastolic arterial blood pressures were 12.9±1.23 and 7.39±0.71 mm Hg, respectively. Mean total cholesterol, triglyceride, HDL and LDL were 4.41±0.96, 1.48±67, 1.49±0.29 and 1.04±0.34 mmol/L, respectively. The mean clearance of creatinine was 94.74±24.58 ml/min.

Conclusion: In our population with high cardiovascular risk,Ramadan fasting was well tolerated with few metabolic complications and a tendency to improve some clinical and metabolic parameters, in particular systolic blood pressure, fasting blood glucose and HDL level.