Evidence-based risk factors for major complications during Ramadan fasting in people with diabetes grouped under IDF-DAR risk categories

• Published in: Diabetes research and clinical practice 2022-03, Vol.185, p.109234-109234, Article 109234
• Main Authors: Rahmatullah, Ahmedani, Muhammad Yakoob, Basit, Abdul, Zia, Shagufta, Hasan, Imran, Masroor, Qazi, Shaikh, Abrar, Khan, Jehangir, Iqbal, Waheed
• Format: Article
• Language: English
• Subjects: Complications; Diabetes; Diabetes Mellitus - epidemiology; Diabetes Mellitus, Type 2 - epidemiology; Fasting - adverse effects; Female; Humans; Hyperglycemia - epidemiology; Hypoglycemia - epidemiology; Hypoglycemia - etiology; Hypoglycemic Agents; IDF-DAR risk categories; Islam; Male; Prospective Studies; Ramadan fasting; Risk Factors
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2022.109234

To identify evidence-based risk factors for major complications during Ramadan fasting in people with diabetes grouped under IDF-DAR risk categories. 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. 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. 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.