Despite their exemption, many Muslim Africans with diabetes observe fasting during ramadan month. This study looked at the nutritional, anthropometric and metabolic impacts of ramadan month fasting in a group of 27 type 2 diabetic Malians recruited from the National Centre for Combating Diabetes in Bamako in spring 2010. The data were collected before, during and after ramadan. In terms of nutrition, women’s energy inputs were lower than those of men, but for the same sex, no difference was noted from one period to the next. During ramadan, the daily number of food intakes was lower and carbohydrate intake was more evenly distributed among meals compared to what was observed outside the ramadan for all subjects. Men had a small loss of weight during ramadan, which continued after the end of ramadan. The measurement of appetite sensations before ramadan and three consecutive weeks during ramadan indicated gender differences in eating. Before ramadan, there were 2 peaks in women at 12: 00 and 18: 00, while men had only one peak at 20: 00. During ramadan, hunger and a desire to eat increased in both sexes until 18: 00 and subsequently decreased. Overall, appetite was felt more strongly than before ramadan. From a metabolic point of view, there was a deterioration in glycaemic control for all subjects, but more markedly in those who had stopped their diabetic medication or reduced doses during ramadan. On the other hand, blood lipids improved significantly during ramadan and even afterwards, with decreases in LDL-cholesterol and total cholesterol/cholesterol ratio of HDL. Blood pressure was increased during ramadan but then returned to the initial values. This study, the first to be conducted in Mali on this subject, shows significant effects of ramadan fasting and highlights the importance of paying attention to the care of diabetes during this particular period.