Can pregnant women with diabetes perform Ramadan fasting safely? Study sheds light

The main finding of the study is that Ramadan fasting improves fasting glucose control and that type 2 diabetes mellitus (T2DM) raises the risk of hypoglycemia. The findings point to the need for more careful and close monitoring of glucose levels and diabetes management strategies in pregnant women with diabetes who decide to fast during Ramadan.

"The study presents a new perspective on glycemic control in this group of patients and may help shape guidelines for managing and monitoring diabetes in pregnant women who choose to fast for Ramadan and ensure their safety," the researchers wrote in their study.

Considering the lack of information about glycemic control in pregnant women with T2DM and gestational DM (GDM) who fast during Ramadan, Salhah S Alsulami, King Abdulaziz University, Jeddah, Saudi Arabia, and colleagues aimed to determine the fasting and postprandial blood glucose levels and to predict the risk factors for hypoglycemia in these patients.

For this purpose, the researchers conducted a prospective cohort research at a single tertiary hospital between 2021 and 2023 involving 70 pregnant women with type 2 diabetes (N=17) and gestational diabetes (n=53) in their second and third trimester.

A comparison was made of fasting and postprandial blood glucose levels during Ramadan to those of the previous month. Hypoglycemia was defined as blood glucose levels less than 60 mg/dl. The risk variables for hypoglycemia were predicted using binary regression.

The study led to the following findings:

• The GDM and type 2 diabetes groups were similar in terms of age, number of fasting days, parity and number of daily fasting hours.
• Only 26.9% of the women who were permitted to fast were given special instructions for Ramadan fasting.
• Dietary intervention was more common in the GDM group, whereas insulin and metformin treatment were more common in the type 2 DM group.
• The fasting glucose level decreased significantly after Ramadan fasting in both groups, from 92.5 mg/dl to 90 mg/dl.
• There was a significantly higher number of hypoglycemia events in the type 2 DM group.
• Type 2 DM was identified as a risk factor for hypoglycemia (OR = 6.23).

"Our findings indicate that Ramadan fasting may improve fasting glucose control," the researchers wrote. "In addition, type 2 diabetes mellitus was identified as a risk factor for hypoglycemia."

However, the authors suggest a clear need for future studies on the safety aspects of this practice and recommend diabetes interventions.

Reference:

Alsulami, Salhah S., and Kholoud A. Ghamri. "Effect of Ramadan Fasting On Blood Glucose Level in Pregnant Women With Gestational and Type 2 Diabetes." Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy, vol. 16, 2023, pp. 3105-3113.