Metabolomic signatures of Ramadan diurnal intermittent fasting in type 2 diabetes mellitus

The global prevalence of type 2 diabetes mellitus (T2DM) is on the rise and projections indicate that an alarming portion of the population will be affected by this disease in the coming decades. In T2DM, chronic hyperglycemia affects the metabolism of the human body. Previous studies on how diabetes impacts metabolism have yielded contradictory results. Therefore, to gain a deeper comprehension of the pathophysiology and progression of diabetes, it is crucial to pinpoint the dysregulated metabolism caused by the disease. In this study, we investigated the alterations in global metabolism in diabetic patients, as well as the effect of Ramadan diurnal intermittent fasting (RDIF) on metabolism. The levels of metabolites that are significantly different in diabetic individuals are components of five pathways: purine metabolism, cysteine and methionine metabolism, arginine and proline metabolism, porphyrin metabolism, and riboflavin metabolism. In diabetic individuals, RDIF significantly altered metabolite levels, affecting three pathways in particular: the pentose phosphate pathway, the tyrosine metabolism, and the D-arginine and D-ornithine metabolism. These pathways share genes previously linked to glycemic control and diabetes. Altogether, this study provides more insight into the beneficial effects of diurnal fasting in controlling diabetes.