There are no studies evaluating the glucose variability in different periods of Ramadan fasting in patients with type 2 diabetes using continuous glucose monitoring (CGM). This study examined the effect of Ramadan fasting on interstitial glucose (IG) variability in early,- late-, and post-Ramadan compared to pre-Ramadan days in non-insulin-treated type 2 diabetes patients. Participants had a CGM system connected 2 or 3 days before Ramadan start, which was removed on the third or fourth day of Ramadan. CGM performance continued for a total of 6 days. A second CGM performance started on the 27th or 28th day of Ramadan and ended on the 4th or 5th post-Ramadan day. First, CGM recordings were divided into pre-Ramadan and early-Ramadan CGM, and second recordings into late-Ramadan and post-Ramadan. At each visit, blood pressure, body weight, and waist circumference were measured, and fasting blood samples were collected for HbA1c and plasma glucose. All patients received recommended Ramadan education before Ramadan. Thirty-three patients (mean age 55.0 ± 9.8 years, 73% males) were prospectively included. IG variability, estimated as mean amplitude of glycaemic excursions (MAGE), increased significantly in early-Ramadan compared to pre-Ramadan (P = 0.006) but not in late-Ramadan and post-Ramadan recording days. Only patients on >2 anti-diabetic drugs (n = 16, P = 0.019) and those on sulphonylureas (n = 14, P = 0.003) showed significant increase in MAGE in early-Ramadan. No significant changes were seen in coefficient of variation, time in range, time in hyperglycaemia, or time in hypoglycaemia. Except for an initial increase in glucose variability, fasting Ramadan for patients with non-insulin-treated type 2 diabetes did not cause any significant changes in glucose variability or time in hypoglycaemia during CGM recording days compared to non-fasting pre-Ramadan period.

Background: Diabetes mellitus (DM) is known to negatively affect quality of life (QoL), yet very few studies have been done on QoL of patients with diabetes in the United Arab Emirates population. Objectives: The aim of this study was to assess the impact of DM on health-related QoL (HRQoL) of patients with diabetes of Emirati nationality. Methods: Two hundred and forty Emirati patients with diabetes, treated at the Dubai Diabetes Center, were randomly selected and interviewed using the Short Form-36 questionnaire to assess HRQoL domains. Appropriate statistical measures were performed to associate HRQoL domains with diabetes-related factors. Results: HRQoL satisfaction scores for physical and mental health domains were very high for the majority of participants. Male participants ranked significantly higher median scores in all HRQoL domains than females (77.36 vs. 65.28, p = 0.004). There was a significant (p < 0.001) negative correlation between diabetes duration and the total averaged score for all sub-domains, and significant (p < 0.001) negative correlations between glycated hemoglobin percentage (HBA1c%) and all sub-domains of HRQoL. Patients without complications had significantly better scores in all HRQoL sub-domains than patients suffering from any complications. Median total HRQoL score for those with neuropathy compared to those without neuropathy was 63.9 versus 82.6 (p < 0.001), for nephropathy was 43.6 versus 72.5 (p < 0.001), for retinopathy 50.7 versus 76.0 (p < 0.001), for ischemic heart disease 54.1 versus 77.3 (p < 0.001), and for cerebrovascular disease 36.7 versus 72.4 (p < 0.001). Multiple regression showed 3 significant predictors for the total averaged score from all HRQoL sub-domains; these were age (p = 0.007), HbA1c% (p < 0.001), and the number of complications related to DM (p = 0.001). Conclusion: HRQoL in Emirati patients with diabetes was significantly associated with the presence of diabetes-related complications, glycemic control, and age of the patient. The assessment of QoL in patients with diabetes can be a valuable measure for the healthcare providers to assess patient’s well-being.

Diabetes mellitus is a major health problem associated with microvascular and macrovascular complications, leading to increased morbidity and mortality. It is rapidly growing worldwide with a huge economical and social burden. Although prevention and treatment of diabetes and its complications play a key role in reducing its morbidity and mortality, they require an integrated team approach at national and international levels. Early diagnosis, correct treatment, and effective follow-up are essential in any health care system to prevent complications of diabetes and ensure patients’ well being.