463 Adults With Type 2 Diabetes Show Lower Depression Scores After Ramadan Fasting: What the Research Shows
Medical disclaimer: This article summarises published research for informational purposes only. It is not medical advice and is not a substitute for guidance from a qualified health professional. Always consult your doctor before starting any fasting protocol, especially if you have an existing health condition or take medication.
Study at a Glance
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| Title | A prospective study of the effect of fasting during the month of Ramadan on depression and diabetes distress in people with type 2 diabetes |
| Journal | Diabetes Research and Clinical Practice |
| Published | July 2019 (Volume 153, pages 145–149) |
| Study type | Prospective cohort (single-arm, before/after) |
| Total participants | 463 |
| Duration | Assessed before and after the one-month Ramadan fasting period |
| Lead researcher | Ebaa Al-Ozairi |
| Institution | Dasman Diabetes Institute, Kuwait |
| Funding | Not reported |
| Note | Written from model training knowledge — PubMed was inaccessible at generation time. Core figures (PHQ-9 change, PAID change, sample size, journal, volume, and DOI) were cross-checked against independent search results before publication. |
| Source | View on PubMed → |
What This Study Looked At
Researchers wanted to know whether a full month of Ramadan fasting — no food or drink from before dawn until sunset, for around 29–30 consecutive days — measurably changes depression symptoms and diabetes-related emotional distress in people already living with type 2 diabetes. Rather than relying on general mood self-reports, the study used two validated instruments: the PHQ-9 depression screening tool and the PAID (Problem Areas In Diabetes) distress scale, administered before and after the fasting month. This adds data to the broader question of whether intermittent fasting helps with depression in a population that also has to manage type 2 diabetes alongside any fasting protocol.
Who Was Studied
| Group | Participants | What They Did |
|---|
| Fasting cohort (type 2 diabetes) | 463 people | Practiced Ramadan fasting (no food or drink from dawn to sunset) for approximately one month while managing existing type 2 diabetes; completed PHQ-9 and PAID questionnaires before and after the fasting month |
| Control | None | This was a single-arm, within-person study — every participant fasted, and results were compared before vs. after Ramadan rather than against a separate non-fasting comparison group |
Participant profile: Adults with pre-existing type 2 diabetes who chose to observe Ramadan fasting. Detailed breakdowns of age range, gender split, and BMI category were not independently verifiable in the sources accessible at generation time.
How Ramadan fasting worked in this study: Participants abstained from all food and drink — including water — from before sunrise until sunset each day for roughly a month, then ate during the hours between sunset and dawn. People with diabetes typically adjust medication timing and dosing around this schedule under medical guidance, since the fasting window is long and occurs daily for the full month rather than being followed a few days a week.
What the Researchers Found
Depression Symptoms (PHQ-9)
| Measure | Change After Ramadan Fasting |
|---|
| PHQ-9 depression score | -3.5 points (95% CI -4.05 to -2.95) |
- Average PHQ-9 depression scores fell by 3.5 points across the cohort after the Ramadan fasting month — a statistically significant drop, since the 95% confidence interval (-4.05 to -2.95) does not cross zero.
- This is a meaningful reduction on a scale where a full category shift (e.g., from "moderate" to "mild" depression severity) typically spans about 4-5 points.
Diabetes-Related Emotional Distress (PAID)
| Measure | Change After Ramadan Fasting |
|---|
| PAID diabetes distress score | -5.02 points (95% CI -6.38 to -3.69) |
- Diabetes-specific emotional distress, measured with the PAID scale, also dropped significantly — by 5.02 points — over the same period.
- Both the depression and diabetes-distress improvements moved in the same direction, suggesting the changes were not limited to one narrow measure.
What Did Not Change
- The relationship between depression improvement and diabetes duration was small and inconsistent: each additional year a participant had lived with diabetes was linked to only a 0.09-point extra drop in PHQ-9 score (95% CI -0.17 to 0.003) — an effect too small and imprecise to call clearly significant.
- Objective glycemic markers such as HbA1c and documented hypoglycemia counts were not part of the psychological outcome results reported here; this study's before/after comparison focused specifically on questionnaire-based depression and distress scores, not blood sugar control itself.
What the Researchers Concluded
The authors concluded that fasting during Ramadan was associated with meaningful reductions in both depression symptoms and diabetes-related emotional distress among people with type 2 diabetes, suggesting the fasting period itself — not just changes in diet — may coincide with psychological benefit in this population.
What This Means If You Fast
- A month of Ramadan-style fasting was linked to a real drop in depression scores in this cohort of adults already managing type 2 diabetes, not just an improvement in general well-being talk.
- Diabetes-related distress eased too. The PAID scale specifically measures the emotional burden of managing diabetes day to day — the fact that it dropped alongside PHQ-9 scores suggests broader gains, not just a mood-scale artifact.
- This is dawn-to-dusk fasting, not typical Western time-restricted eating. See Ramadan fasting vs. intermittent fasting for how a 29-30 day, no-water Ramadan fast differs from something like a daily 16:8 window.
- If you have diabetes, medical supervision matters. Anyone with diabetes considering an extended fasting period like Ramadan should read can diabetics do intermittent fasting safely and coordinate medication timing with their doctor before fasting.
- Longer time with diabetes didn't predict a bigger or smaller benefit. The study found only a weak, non-significant link between years since diagnosis and the size of the depression-score improvement — so this benefit wasn't limited to people newly diagnosed or only those with long-standing disease.
- Individual results vary, and cohort averages don't guarantee every person's depression symptoms will improve the same way.
Study Limitations
- Sample size was moderate (463 participants), but the study used a single-arm, before/after design with no non-fasting control group, so the improvement cannot be fully separated from other things that happen during Ramadan — changes in social routine, sleep timing, and community context among them.
- Depression and distress were measured with self-reported questionnaires (PHQ-9 and PAID), which can be influenced by recall and by the broader social and religious context of the fasting month itself.
- Detailed demographic breakdowns (exact age range, gender split, BMI) were not independently verifiable in the sources accessible at generation time.
- The study population was specifically adults with type 2 diabetes, so findings may not generalize to healthy adults or to people fasting outside a Ramadan context.
- Funding source was not reported in the available sources, so potential conflicts of interest cannot be assessed from this article.
Source
Al-Ozairi E, et al. (2019). A prospective study of the effect of fasting during the month of Ramadan on depression and diabetes distress in people with type 2 diabetes. Diabetes Research and Clinical Practice, 153, 145-149. PMID: 31108138
Frequently Asked Questions
Does Ramadan fasting help with depression symptoms?
In this study of 463 adults with type 2 diabetes, average PHQ-9 depression scores fell by 3.5 points (95% CI -4.05 to -2.95) after the Ramadan fasting month compared with before — a statistically significant reduction.
Does intermittent fasting reduce diabetes-related stress?
In this study, diabetes-specific emotional distress, measured with the PAID scale, dropped by 5.02 points (95% CI -6.38 to -3.69) after Ramadan fasting, suggesting fasting coincided with lower day-to-day diabetes burden as well as lower depression scores.
Is this study proof that fasting causes lower depression?
Not on its own. This was a single-arm, before/after cohort study without a non-fasting control group, so it can show an association between the fasting month and lower scores but cannot rule out other factors that occur during Ramadan, such as changes in routine or social support.
Is Ramadan fasting safe for people with type 2 diabetes?
Ramadan fasting can be safe for many people with type 2 diabetes but requires medical supervision, especially around medication timing and hypoglycemia risk — see can diabetics do intermittent fasting safely for more detail.
Does how long someone has had diabetes affect whether fasting improves their mood?
Not clearly, according to this study. Each additional year with diabetes was linked to only a 0.09-point extra improvement in PHQ-9 score (95% CI -0.17 to 0.003), an effect too small and imprecise to be considered statistically significant.
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