Effects of Ramadan Fasting on Children and Young Adults with Type 2 Diabetes during the COVID-19 Pandemic: A Prospective Study
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Objectives
The COVID-19 pandemic created unique circumstances for Ramadan fasting (RF) that have not been previously experienced in recent history. This study aimed to explore the impact of RF on lifestyle patterns, mental health, and glycaemic control among young people with type 2 diabetes (T2D) during the COVID-19 pandemic in the UK.
Methods
A prospective, observational, crossover, pilot study was conducted. The study participants included children and young adults with T2D aged 12-24 years, who practised RF for a minimum of 10 days. The study was conducted in three diabetes centres in the UK from March 2021 to June 2021. SoGoSurvey software was used to design online questionnaires that were used to collect data, including demographic information, medical history, impacts of the COVID-19 pandemic (weight and mental health) and lifestyle (diet patterns, physical activities and sleeping patterns). They were completed by the target age group 2 weeks before and 2 weeks after the month of Ramadan. Statistical analyses were performed using SPSS. Ethical approvals were obtained from the Health Research Authority (HRA) and from the Health and Life Science Faculty Research Ethics Committee at De Montfort University.
Results
Nine participants with T2D, including 7 females and 2 males aged from 14-22 years old (Mean ± SD; 17±3). Half of the participants (N=4) fasted safely the whole month of Ramadan. Participants reported that they fasted because of the health benefits (N=7) and they felt better during fasting (N=4). The glucose parameters, including HbA1c (P = 0.715), weight (P = 0.343), and body mass index (BMI) (P = 0.249), showed no statistically significant difference before and after RF. Most participants (N=8) were less active during fasting, and an altered sleeping pattern was reported (N=4). RF was associated with increased consumption of fruits and vegetables (N=4), decreased bread consumption (N=3) and an increase in consumption of desserts (N=3). In the period before RF, participants (N=4) reported that the COVID-19 pandemic was associated with weight gain, and this was not noticed during RF. Deterioration in mental health issues before RF (stress; N=3, emotional issue; N=3, depression; N=2) was reported by participants who had weight gain.
Conclusion
Young people, including children with T2D in the UK, fasted the whole month of Ramadan with no complications. Fasting during the COVID-19 pandemic was associated with a variable diet and improvement in mental health in study participants with T2D. Larger studies are necessary to determine the importance of education sessions before RF in the UK.
