Fasting of Ramadan in peoples with diabetes in Benghazi, Libya: an exploratory study

Figures & data

Fig. 1. Percentage of causes of breakfasting during Ramadan.

Table 1. General characteristics of the study group

	Males	Females	p-value	Total
Number of patients	248	245		493
Mean age(years)	60.2±12.7	57.9±10.5	0.029	59±11.7
Mean duration of diabetes (years)	11.4±7.5	11.2±7.8	0.7	11.3±10
No dose change	27.4%	26.1%	0.74	26.8
Mean number of fasted days	29.24±2.6	27.8±5.9	0.001	28.5±4.6
Fasted complete month	73.8%	66.9%	0.09	70.4%
≥15 days fasting	99.6%	95.6%	0.003	97.5%
Mild hypoglycemia	14.1%	15.1%	0.75	14.6%
Severe hypoglycemia	1.6%	4.9%	0.04	3.2%
Hyperglycemia	12.9%	9.4%	0.21	11.2%
Admission	4.8%	5.3%	0.81	5.1%
Type-2	94.4%	95.9%	0.42	95.1%
Mean HbA1c	7.9%±1.7	7.6%±1.4	0.26	7.8%±1.6
HbA1c checked 3 m	37.9%	40%	0.63	38.9%

± Refers to standard deviation. HbA1c checked 3 m: Percent of patients who had their HbA1c checked within three months before Ramadan.

Table 2. Comparison between type-1 and type-2 diabetics

	Type-1	Type-2	p-value	All
Number of patients	24	469		493
Mean age (years)±SD	38.3±15	60.1±10.5	0.000	59±11.7
Mean duration(years)±SD	14.2±11.3	11.2±7.4	0.06	11.3±10
No dose change	25%	26.9%	0.84	26.8
Mean fasting (days)±SD	27.5±6.6	28.5±4.5	0.29	28.5±4.6
Full fasting	70.8%	70.4%	0.96	70.4%
≥15 days fasting	95.8%	97.7%	0.57	97.5%
Mild hypoglycemia	20.8%	14.3%	0.3	14.6%
Severe hypoglycemia	4.2%	3.2%	0.79	3.2%
Hyperglycemia	20.8%	10.7%	0.12	11.2%
Admission	8.3%	4.9%	0.45	5.1%
Males	58.9%	49.9%	0.42	50.3%
Mean HbA1c±SD	8.2%±1.7	7.7%±1.6	0.32	7.8%±1.6
HbA1c checked	45.8%	38.59%	0.47	38.9%

Table 3. Comparison between type-2 patients according to the type of treatment

	Insulin	Oral anti-diabetics	p-value	Diet alone
Number of patients	357	101		11
Mean age (years)±SD	60.5±10.1	59.6±11.3	0.43	50±9.7
Mean duration (years)±SD	12.6±7.3	6.8±5.8	0.000	6.1±3.9
Mean HbA1c (%)±SD	7.8%±1.4	7.7%±1.8	0.78	7%±2.1
HbA1c checked	34.1%	47.5%	0.014	90%
Mean fasted days±SD	28.5±4.7	28.6±4.1	0.76	29.9±0.3
Mild hypoglycemia	14.2%	15.8%	0.69	0
Severe hypoglycemia	3.9%	0.99%	0.14	0
Severe hyperglycemia	10.9%	9.9%	0.76	9%
Admission rate	4.7%	5.9%	0.63	0

Fig. 2. Time trend of hypoglycemia and hyperglycemia during Ramadan.

Table 4. Incidence of acute glycemic derangement

	Total number of episodes	Incidence rate
Mild hypoglycemia	132 episodes	26/100 patient/month
Sever hypoglycemia	24 episodes	4.8/100 patient/month
Hypoglycemia requiring admission	1 episodes	0.2/100 patient/month
Any hypoglycemia	156 episodes	31/100 patient/month
Severe hyperglycemia	84 episodes	17/100 patient/month
Hyperglycemia requiring admission	5 episodes	1/100 patient/month

Table 5. Comparison between BDEC study and EPIDIAR study

	BDEC study (Benghazi, Libya)	EPIDIAR (13 Muslim country)
Lunar year (Gregorian)	1429 Hijri (2008)	1422 Hijri (2001)
Total number of patients	493	12,243
Number of patients/country	493	757–1,357
Percentage of Type-2 DM	95.1%	91.3%
Mean age for type-1±SD	38.3±15 years	31±12.7 years
Mean age for type-2±SD	60.1±10.5 years	54±11.0 years
Mean duration of type-1 DM±SD	14.2±11.3 years	10±7.6 years
Mean duration of type-2 DM±SD	11.2±7.4 years	7.6±5.8 years
Dose changes during Ramadan	73.2%	27.9%
Type-1 fasting ≥ 15 days	95.8%	9.4–71.6%
Type-2 fasting ≥ 15 days	97.7%	57.8–89.8%
Mean fasting for type-1	27.5 days	18.1–25.6 days
Mean fasting for type-2	28.5 days	23.9–28.5 days
Hypoglycemia requiring admission	0.2%	2.6%
Hyperglycemia requiring admission	1%	4.7%