Effects of Ramadan Fasting on Children and Young Adults with Type 2 Diabetes during the COVID-19 Pandemic: A Prospective Study

Abstract

Background: The COVID-19 pandemic created unique circumstances for observing Ramadan Fasting (RF), unlike any encountered in recent history. This study aimed to explore the impact of RF on lifestyle patterns, mental health, and glycaemic control among young people living with Type 2 Diabetes (T2D) in the UK during the pandemic period.
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 carried out in three diabetes centres in the UK from March 2021 to June 2021. SoGoSurvey software was used to design online questionnaires that collected data on demographics, medical history, the impacts of the COVID-19 pandemic (weight and mental health), and lifestyle factors (diet patterns, physical activities, and sleep patterns). These questionnaires were completed by the target age group 2 weeks before and 2 weeks after 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 seven females and two males aged 14 to 22 years (Mean ± SD; 17 ± 3), took part. Half of the participants (n = 4) fasted safely the whole month of Ramadan. Participants reported fasting for health benefits (n = 7), and some felt better during fasting (n = 4). 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 altered sleep patterns were reported (n = 4). RF was associated with increased consumption of fruits and vegetables (n = 4), decreased bread consumption (n = 3) and increased consumption of desserts (n = 3). Before RF, participants (n = 4) reported that the COVID-19 pandemic was associated with weight gain, a finding that was not observed 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 gained weight.
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 varied dietary patterns and improvements in mental health among study participants with T2D. Larger studies are necessary to generalise these findings and to determine the importance of education sessions before RF in the UK.