Abdulrahman Hassan A Alfahadi is a medical student at College of Medicine, King Saud University 2019.

His research experience is:

Comparison of the effectiveness of smart applications versus conventional health care measures on body composition, cardiovascular risk, neurocognitive functions, and quality of life in obese subjects (funded by Dallah Hospital – in progress)

 Assessment of the relationship between cognitive functions and fasting effects on patients with Type 2 Diabetes Mellitus (Principal Investigator – in progress)

 Serum inducible and endothelial nitric oxide synthase activity in patients with Type 2 Diabetes Mellitus in relation to Coronary Artery Disease (at level of submission)




One of the complications of diabetes is the progressive decrease in mental abilities and cognition, in particular; processing speed and verbal memory, ultimately leading to dementia.The purpose of the present study was to see the effect of  fasting during the Ramadan month on cognitive functions and fatigue severity in type 2 diabetes mellitus (T2DM)and compare it with control group Muslims using The Cambridge Neuropsychological Test Automated Battery (CANTAB).


This observational case control study was conducted at the King Khalid University Hospital, Riyadh, Saudi Arabia in control subjects (n=41) and patients with T2DM (n=39).The groups subjects were matched for age, BMI, and gender. The tests included a validated Arabic form of standardized Fatigue severity scale (FSS) .The tests selected from CANTAB battery were Motor Screening Task (MOT), Intra-Extra Dimensional Set Shift (IED) and Spatial Span (SSP) which test motor functions, rule acquisition and reversal and working memory capacity respectively. All subjects were metabolically stable without history of cognitive impairmentor  psychiatric disease (Anxiety and depression).


During Ramadan there were significant differences in IED errors (24.43 ± 20.82 vs 50.73 ± 56.21 P=0.007) , IED stages completed (7.43 ± 2.43 vs  8.69 ± .73 , P=0.003), MOT (1466.32 ± 559.29 vs 1120.27 ± 343.09 , P= 0.002) , and SSP SL (4.13 ± 1.36 vs 4.82 ± 1.60 ,P= 0.05) in diabetics versus control. The differences significantly persisted even in the post Ramadan period among the two groups.  IED errors (52.62± 60.62vs 20.95± 16.90P=0.003) , IED stages completed (7.54± 2.50vs  8.7± .73 , P=0.003) . Motor Screening Task (MOT) Mean latency significantly decreased after Ramadan (1268.91 ±  297.52  vs 1047.41 ±  375.32, P=0.002). In T2DM there was significant decrease in MOT latency and a significant increase in SSP span length (4.32±1.33 vs 4.71±1.35, p= 0.025). In control subjects the effect on all tests was non-significant. Among the FSS items there were no significant differences in all items of FSS in control while Significant differences were observed in many items that shows T2DM patients have more fatigue symptoms than control


Ramadan fasting significantly affects the fatigue scales and neurocognitive functions in patients with T2DM in terms of (MOT)  motor performance,  (IED) flexibility of attention & more errors and (SSP) working memory capacity. These indicators remain worse in the post Ramadan period also.

 Large scale studies with educational counseling and proper management protocols are required to control the effects of Ramadan on cognitive decline in T2DM patients.