Changes in glycemic control and blood pressure during the Assumption Fast in Ethiopian Orthodox Christians with type 2 diabetes mellitus: a prospective observational study.

BACKGROUND

Type 2 diabetes mellitus (T2DM), frequently complicated by hypertension, poses significant challenges in low-resource settings. Christian Orthodox fasting, a structured religious practice relevant in regions like Ethiopia remains understudied for its metabolic benefits and risks.

METHODS

Prospective observational study was conducted on T2DM patients who had been fasting during the Assumption fast and attended the outpatient clinic from August 7 to August 22, 2024, at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. The primary outcomes were changes in fasting blood glucose and blood pressure levels assessed before and after the fasting period. SPSS version 26 was used for data analysis. Descriptive statistics were used to summarize data before and after the fasting period, and a paired t-test assessed the significance of differences between the means of two sets of data. RESULT: The study included 68 patients with T2DM, with a mean age of 56.5 years; 52.9% of participants were male. Mean fasting blood glucose was observed to decrease by 19.56 mg/dL during the fasting period (p = 0.001). The proportion of participants with fasting blood glucose within the target range of 80–130 mg/ dL increased from 67.6% at baseline to 91.2% at the end of fasting period. Similarly, mean blood pressure values were observed to decline during the fasting period, with systolic blood pressure decreasing by 9.19 mmHg and diastolic blood pressure by 9.44 mmHg (p = 0.001). Additionally, the proportion of patients exceeding hypertensive thresholds (SBP > 130 mmHg, DBP > 80 mmHg) declined by 19.2% and 38.3%, respectively, during the fasting period.

CONCLUSION

Our study showed that Orthodox Christian fasting was associated with changes in glycemic control and blood pressure management in T2DM patients. Multicenter trials with larger and diverse cohorts as well as long-term follow-up are needed to assess the sustainability of these associations and refine protocols. CLINICAL TRIAL NUMBER: Not applicable.