Survey on diabetic patients treated with insulin during the fasting month of Ramadan

Abstract

Aim

To estimate the proportion of diabetic patients on insulin, who interrupt fasting during Ramadan, and describe the reported reasons of this interruption.

Design

This is a national observational survey of diabetic patients treated with insulin and fasting during the month of Ramadan 2013, proposed to all endocrinologists willing to participate. Consecutive patients were included until the required sample size, estimated at 498 patients, was obtained. Conducted among patients recruited by endocrinologists during the month following Ramadan 2013.

Results

Five hundred twenty-six (526) patients were included, of which 51 (9.7%) had type 1 diabetes. The mean age was 36.8 ± 11.6 and 58.3 ± 10.0 years for type 1 and type 2 diabetes, respectively. The proportions of male subjects were 62.8% and 57.5% for type 1 and type 2 diabetes, respectively. The mean duration of diabetes was 11.0 ± 8.8 and 14.4 ± 7.9 years for type 1 and type 2 diabetes, respectively. During Ramadan, more than 55% (54.9% and 55.8% for type 1 and type 2 diabetes, respectively) of patients were treated with insulin analog and over a third with mixed insulin. In this study population, 71.5% reported having fasted without interruption during the month of Ramadan. The average number of non-fasted days was 3.0 ± 6.7, mainly due to hypoglycemic episodes.

Conclusion

According to this observational survey conducted in Tunisia, most patients with diabetes treated with insulin (insulin in more than half of the cases) were able to fast without interruption during Ramadan.

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Keywords:

• fasting
• Ramadan
• insulin
• diabetes type 1
• diabetes type 2

Acknowledgments

The authors acknowledge SANOFI laboratory for supporting this study and all the investigators: Borni Zidi, Haroun Ouertani, Amel Jaidane, Bassem Louzir, Faida Ajili, Myrvet Kammoun, Yamina Fourti, Samia Sellami, Leila Cheraga, Kamel Ben Rebia, Awatef Mekawer, Jazia Hamzaoui, Awatef Marouani Ousleti, Bochra Fetouhi, Ines Khochtali, Fatma Haj Youssef, Dorsaf Skhiri, Riadh Miladi, Sameh Fradi, Habib Sfar, Meriem Ferchichi, Ilhem Ardhaoui, Amel Maaroufi, Nada Dellel Youssef, Ibtissem Jaballah, Salambo Ernez, Larbi Chaieb, Molka Chadly Chaieb, Maha Kacem, Jamil Belaid, Mounir Garali, Adnene Derbel, Jamel Souilem, Lotfi Cherif, Maria Hadded, Fatma Boussema, Fethi Derouiche, Faycal Jait, Said Chammakhi, Meriem Ennabli Nawer, Basma Cheour, Hichem Terzi, and Mohamed Aissaoui.

Disclosure

Dr Abid reports receiving payment as principal investigator, and Dr Hsairi reports receiving payment as the biostatistician for this study. Dr Ben Aissa participated in writing the manuscript as membre of medical department in SANOFI Tunisia Morroco. The authors report no other conflicts of interest in this work.