Assessment of Fasting Outcomes in Different Risk Groups of Patients with Type 2 Diabetes during Ramadan Who Intended to Fast

A bstract Background: Ramadan is one of the five pillars of Islam. Despite knowing the health risks, many patients with diabetes are very keen to fast during Ramadan for religious reasons. Objectives: The primary outcome of this study is to assess the risk (hyperglycemia, hypoglycemia, dehydration, and others) of fasting during Ramadan in patients with type 2 diabetes in various risk categories. Methodology: This was a 3-month prospective study that was performed from February 6, 2024, to May 24, 2024 (6 weeks before Ramadan until 6 weeks after Ramadan), at the outpatient department of a tertiary care hospital and the private practice of an individual researcher in Bangladesh. A total of 250 patients with type 2 diabetes mellitus were enrolled as study subjects using a random sampling technique, and data were collected using a structured questionnaire. All study subjects were categorized into three risk groups (high, moderate, and low) according to the International Diabetes Federation—Diabetes and Ramadan International Alliance 2021 risk calculator before Ramadan. At the post-Ramadan follow-up, 40 participants were lost to follow-up, and final analysis was conducted on 210 participants. We used MS Office tools and the Statistical Package for the Social Sciences version 23.0. Continuous variables were summarized using means and standard deviation, and categorical variables were summarized using frequency distribution. The difference between the findings was ascertained by a t test for continuous variables and the chi-square test for categorical variables. Results: The overall mean age was 55.3 ± 13.5 years. About half of the participants were housewives (52.8%), as females were the predominant group (62.4%). The remaining participants were engaged in service (27.6%), retired (10.4%), business (5.2%), and farming (4.0%). The risk categorization showed that 107 (42.8%), 81 (32.4%), and 62 (24.8%) of the participants were in the low-, moderate-, and high-risk categories, respectively. At the post-Ramadan follow-up, 55.3% of the high-risk group ( n = 47) fasted for all 30 days, whereas 44.7% fasted for fewer days. About 96.7% of the moderate-risk group ( n = 60) completed 30 days, whereas 3.3% fasted for fewer days. All patients in the low-risk group ( n = 103) fasted for all 30 days. The difference between groups was statistically significant ( P < 0.001). There was a significant association between the diabetic risk group and history of adverse events during Ramadan ( P < 0.001). About 23.4% ( n = 11) of the high-risk group and 3.3% ( n = 2) of the moderate-risk group experienced hypoglycemia, respectively, who fasted for fewer days. Hyperglycemia (17.0%) and dehydration (4.25%) occurred only in the high-risk group. No significant changes occurred in either the blood sugar profile or creatinine levels between pre- and post-Ramadan. Conclusion: A statistically significant number of participants in the high-risk group fasted for all 30 days without any complications.