Improved diabetes control after prolonged fasting - The Ramadan model

We studied the effect of one large evening meal (gorging-type diet) on patients with diabetes mellitus, during the month of Ramadan. Observant Muslims refrain from food and drink during the day and eat a large meal after sundown. It was an observational study carried out under field conditions in the Bedouin town of Rahat, in the northern Negev area of Israel. Fasting diabetic subjects were studied before, at the end of, and one month after Ramadan. Body weight, changes in medication, frequency of acute complications, plasma glucose and hemoglobin A_1c were determined. Sixty-seven fasting Muslim diabetic patients were studied. A significant decrease in hemoglobin A_1c (HbA_1c; p<0.001) was observed at the end of the month of fasting. There was no significant change in the total daily dose of antidiabetic agents, or in the incidence of acute diabetic complications. The gorging-type diet, followed for one month, was well tolerated and safe. A statistically significant decrease in HbA_1c suggests a beneficial effect of the Ramadan fast in these patients.