RESUMO
OBJECTIVE: The 'PROspective Study of dose adjustment of multiple anti-diabetic therapy for Type-2 diabetic patients FASTing the Month of Ramadan aimed to assess the biophysical and metabolic effects of fasting during Ramadan, including HbA1c, weight, blood pressure and lipid profile. STUDY DESIGN METHODS: We performed a prospective study of people with Type-2 diabetes who were on ≥3 drugs for lowering glucose before and after Ramadan of H1438 (May-June 2017) in Hamad Medical Corporation, Qatar. We enrolled 228 participants, of whom 181 completed the study and were included in the analysis. RESULTS: There were 115 (63.5%) men and 66 (36.5%) women, mean age 53.6⯱â¯9.7â¯years and mean diabetes duration of 10⯱â¯6â¯years. Both HBA1c [7.8% (62â¯mmol/mol) vs. 7.6% (60â¯mmol/mol); pâ¯=â¯0.004]; and diastolic BP (75.7⯱â¯8.55 vs. 68.8⯱â¯23.1â¯mmHg, Pâ¯=â¯0.001) improved significantly after Ramadan while there was an increase in total cholesterol (3.94⯱â¯0.89â¯mmol/l vs 4.11⯱â¯1.02â¯mmol/l; pâ¯=â¯0.008) and triglycerides (1.55⯱â¯0.72â¯mmol/l vs 1.71⯱â¯0.9â¯mmol/l; pâ¯=â¯0.012). Subgroup analysis showed that patients on sulphonylurea, South Asians and males had a significant reduction in both HBA1c and weight. CONCLUSION: Patients with Type 2 diabetes who fast during Ramadan show an improvement in glycaemic control and diastolic blood pressure, but a worsening of total cholesterol and triglycerides, particularly those of South Asian origin and men.