Résumé:
The fasting of Ramadan is one of the five pillars of Islam. Many sick patients whose diabetics
fast despite the religious exemption granted by the Holy Qur'an.
The objective of this thesis is to study the effects of the fast of the Ramadan in a population of
diabetics.
A multicentric study using questionnaires on 13 cities in Algeria carried on the follow-up of
2708 diabetics before, during and after the month of Ramadan. The first part related with the
analysis of the behavior of diabetics with regard to Ramadan fasting and to know the points of
views of physicians, religious and diabetics association staffs. A second part concerned
complication related to fasting, biochemical and clinical parameters, diet, anthropometry and
physical activity of diabetics in addition to healthy controls. The last part of this thesis was to
evaluate the impact of nutritional education sessions (NES) on a population of 158 type 2
diabetics by comparing two groups of subjects
The results showed that no fasting diabetics (NFDTM) treated the subject of fasting with
physicians significantly more than fasters (93.6% vs 54.7%; p=0.0000). Decision-making
factors of fasting diabetics (FDTM) were more oriented towards religious beliefs than social
or clinical (p<0.001). A multidisciplinary collaboration (physicians, religious, association) to
better advise diabetics has been approved by all actors in the management of diabetes.
The second part of this thesis has shown that fasting Ramadan is a risk factor to have at least
one complication in the FDTM. Patients with Type 1 diabetes mellitus had a higher risk of
complications from 2 to 5 times more than Type 2 diabetes mellitus. The biochemical and
clinical assessment, diet, anthropometry and physical activity have seen changes during
Ramadan. A principal component analysis showed that overweight FDTM’s were more
affected by hyperglycemia than NFDTM’s.
The third part of this thesis revealed that the energy intake of diabetics following NES did not
differ significantly during and outside Ramadan (p>0.05). The opposite was observed in the
group that did not follow these NES (p<0.05). The equilibrate reports were more in favor of
the recommendations for diabetics who followed the NES. The anthropometric parameters did
not undergo significant changes during the month of Ramadan
A large number of diabetics fasted despite the prohibition of religion and the opinion of the
doctor. The fasting of Ramadan has had some positive effects on diabetics. Dialogue,
awareness and follow-up of the NES resists the quality of the diabetic patient. They must be
multidisciplinary to ensure better continuity of care. This study is a scientific basis of research
for the development of the topic of Ramadan and diabetes.
