Effect of Fasting during Ramadan on Inflammatory Markers in Type II Diabetes Mellitus

Background: Studies have recognized an association between inflammation and T2DM and its complications. Fasting is used as a medical treatment for a variety of ailments. For all healthy adult Muslims, fasting throughout Ramadan is a religious obligation.

Aims: The goal of this study was to back up a recent discovery about the regulatory effects of Ramadan fasting on inflammation in T2D patients.

Study Design: A cross-sectional study was conducted.

Date and Location of Study: The study was conducted in Benghazi Diabetes Center in April 2019, two weeks before the holy Ramadan. Methodology: Blood samples for inflammatory markers (WBC, hs- CRP, Fibrinogen) and glycemic control, fasting blood sugar (FBS), and HbA1C were collected from 72 patients with type 2 diabetes from Benghazi diabetic clinic two weeks before the holy Ramadan fasting.

Following up (at least after the first ten days of Ramadan fasting), another sample of the same Laboratory testing was taken. The difference was tested using a paired T-test, with a P- value of less than 0.05 being considered significant. The trial was completed by 58 individuals, and 14 patients were dropped out.

Results: Our findings revealed that there was no significant difference in FBS and hs-CRP levels before and during Ramadan fasting, but Fibrinogen levels were significantly different (P = <0.001) before and during Ramadan fasting, with Fibrinogen levels being higher during fasting. Interestingly, WBC levels were lower during than before fasting, with the difference being slightly significant (P = .06). When it comes to differential counts (neutrophils P =.009, lymphocytes P = .746), The hemoglobin (P=< 0.001) and platelets (P=.028) were significantly lower during Ramadan fasting compared to pre-Ramadan level.

During Ramadan fasting, the mean value of fasting blood sugar, hs-CRP, and WBC was lower in a group of patients with HbA1C less than 7 compared to a group with HbA1C greater than 7, although the difference was not statistically significant. Fasting blood sugar during Ramadan was strongly connected with hs-CRP (Pearson correlation = 0.289, P =.032), but not with HbA1C, even after adjusting for age, waist circumference, and BMI.

The interval of diabetes was not related to any of the inflammatory indicators examined in this investigation.

Conclusion: Except for WBC count, fasting Ramadan (first ten days) had no significant effects on most inflammatory indicators.