Evidence-based risk factors for major complications during Ramadan fasting in people with diabetes grouped under
Rahmatullah1, Muhammad Yakoob Ahmedani2, Abdul Basit2
1Consultant Diabetologist and Endocrinologist, Bolan Medical Complex Hospital (B.M.C.H), Quetta, Pakistan.
Insights
Identifying risk factors for major complications in people with diabetes fasting during Ramadan is crucial. Key factors include male gender, certain medications, and pre-existing conditions, necessitating pre-Ramadan risk assessment.
Area of Science:
- Endocrinology and Metabolism
- Public Health
- Clinical Diabetes Management
Background:
- Ramadan fasting poses unique challenges for individuals with diabetes.
- Understanding risk factors for complications during fasting is essential for patient safety.
- The International Diabetes Federation Diabetes and Ramadan (IDF-DAR) risk stratification is a valuable tool.
Purpose of the Study:
- To identify evidence-based risk factors for major complications during Ramadan fasting in people with diabetes.
- To stratify participants into IDF-DAR risk categories to guide risk assessment.
- To inform preventative strategies for managing diabetes during Ramadan.
Main Methods:
- Prospective observational multicenter study conducted from April to June 2019.
- Recruitment of 1045 individuals with diabetes intending to fast during Ramadan.
- Pre-Ramadan assessment including demographic data, risk categorization, and structured education; post-Ramadan assessment of complications.
Main Results:
- Two-thirds of participants were categorized as very high- or high-risk.
- Frequencies of major hypoglycemia, major hyperglycemia, hospitalization, and breaking the fast were 4.4%, 10.8%, 0.8%, and 3.1%, respectively.
- Identified risk factors included male gender, sedatives/antidepressants, type 1 diabetes (hypoglycemia); history of DKA/HHS (hyperglycemia, hospitalization); older age, acute illness (hospitalization).
Conclusions:
- Evidence-based risk factors for major Ramadan fasting-related complications in people with diabetes were identified.
- Pre-Ramadan risk assessment is imperative to recognize and mitigate these identified factors.
- This study provides crucial insights for optimizing diabetes care during Ramadan.
Aim:
To identify evidence-based risk factors for major complications during Ramadan fasting in people with diabetes grouped under IDF-DAR risk categories.
Methods:
This prospective observational multicenter study was conducted by Baqai Institute of Diabetology and Endocrinology (BIDE) between April-June 2019. People with diabetes having intention to fast during Ramadan were recruited. Demographic data collection along with risk categorization was done during pre-Ramadan visit. Structured education was given on one- to-one basis to each of the study participants. Assessment of complications was done during post Ramadan visit.
Results:
A total of 1045 people with diabetes participated with near equal gender distribution. Two thirds of study population was grouped into very high- and high-risk categories. Frequencies of major hypoglycemia, major hyperglycemia, hospitalization & need to break the fast were 4.4%, 10.8%, 0.8% & 3.1% respectively. On multivariate analysis, the risk factors found for major hypoglycemia during Ramadan were male gender, use of sedatives & antidepressants & having type1 diabetes mellitus, history of DKA/HHS during last 3 months for major hyperglycemia, major hypoglycemia & hospitalization for breaking of fast while older age, acute illness, and major hypoglycemia were identified factors for hospitalization.
Conclusion:
In this prospective study evidence-based risk factors for fasting related major complications were identified in people with diabetes. It is imperative to recognize these factors during pre-Ramadan risk assessment visit.
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