Glycemic variability before and during Ramadan fasting among adults with type 2 diabetes and hepatic cirrhosis: a prospective paired cohort using real‑time continuous glucose monitoring (CGM)
Authors' conclusion
In adults with diabetes and compensated cirrhosis (Child-Pugh A), Ramadan fasting did not worsen glycemic variability, and hypoglycemia risk remained minimal. Fasting appeared safe in well-selected patients, particularly those classified as low-to-moderate IDF-DAR risk, whereas high-risk or decompensated cirrhosis patients should be counseled against fasting.
Study context
- Population
- Adults with T2D and cirrhosis, Jakarta, January-March 2025completed paired CGM
- Participants
- 32 adults
- Exposure
- During Ramadan fasting vs pre-Ramadan
- Outcome
- Coefficient of variation (CV)
Methodological detailssingle-center, real-time CGM
- Single-center
- Real-time CGM
Main finding
As reported in the abstract
P = 0.84
Observational data: associations, not effects.
Secondary outcomes
| Outcome | P value |
|---|---|
| TAR by IDF-DAR riskHigh-risk (IDF-DAR risk score > 6) vs Low-moderate risk · greater increases in TAR with high-risk | P = 0.048 |
Time in range (TIR)
- Modest, non-significant increase in TIR
- +4.0 pp
Time above range (TAR)
- Mild rise in TAR
- +5.2 pp
Ambulatory glucose profiles (AGP)
- Reduced daytime variability with distinct post-meal excursions at suhoor and iftar
Safety
| Outcome | Pre-Ramadan | During Ramadan | P value |
|---|---|---|---|
| TBR | <1% | <1% | P = 0.75 |
Original publication
Glycemic variability before and during Ramadan fasting among adults with type 2 diabetes and hepatic cirrhosis: a prospective paired cohort using real‑time CGM. Diabetes Res Clin Pract. Published 27 November 2025. doi:10.
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