Glucometric parameter changes in patients with type 2 diabetes during ramadan fasting: A prospective comparative real-world study

Background: This study assessed glucometric changes in Type 2 diabetes mellitus (T2DM) patients before, during, and after Ramadan fasting using an intermittently scanned continuous glucose monitoring system (isCGMS). Methods: This prospective comparative study included T2DM patients aged 30-70 years who were receiving nonintensive insulin in Riyadh, Saudi Arabia. In addition to the baseline characteristics, glycated hemoglobin (HbA1c) and ambulatory glucose profile (AGP)-derived metric data were collected at three specific points: pre-, during-, and post-Ramadan. Self-care activities during Ramadan were evaluated using the Diabetes SelfManagement Questionnaire (DSMQ). Results: Overall, a total of 93 T2DM patients were enrolled in the study. Their mean age +/- SD age was 47.9 +/- 7.5 years, and 51.6 % of them were males. Compared with pre- and post-Ramadan, there was a significant decrease in HbA1c (p < 0.001 for both periods), average glucose level (p = 0.001 and p = 0.026, respectively), glucose variability (p = 0.043 and p = 0.005, respectively), and % time above the range of 181-250 mg/dL (p < 0.001 for both periods), as well as a significant increase in % time in target (70-180 mg/dL) during Ramadan (p < 0.001 for both periods). However, the % time below 54 mg/dL was slightly greater during Ramadan than both pre- and post-Ramadan (p <0.001 and p = 0.002, respectively). Furthermore, 32.3 % reported inadequate selfcare behaviors during Ramadan. Conclusions: Ramadan fasting could improve glucose levels in T2DM patients who were not on intensive insulin, with a relatively low incidence of hypoglycemia.