Feasibility of Ramadan fasting in adults with type 1 diabetes: an observational study

Elbarsha, Abdulwahab; Elmehdawi, Rafik; Eljazwi, Imhemed; Buzaid, Najat; Mahgob, Nezar; Elhemri, Maisoon

doi:10.1007/s13410-017-0575-0

Cited by 3 publications

(3 citation statements)

References 8 publications

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“… 1 However subsequent studies of type 1 diabetes and Ramadan failed to show similar results. 4 , 16 , 17 Our study is a hospital-based and the higher frequency of DKA observed in those who were fasting at time of admission may not represent a true increase in incidence of DKA in these patients. An incidence study from the same city showed no increase in the total DKA rate during Ramadan.…”

Section: Discussionmentioning

confidence: 76%

Outcomes and hospital admission patterns in patients with diabetes during Ramadan versus a non-fasting period

Elbarsha

Elhemri

Lawgaly

et al. 2018

Annals of Saudi Medicine

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BACKGROUNDFasting during Ramadan is a challenge for Muslim patients with diabetes and for their healthcare providers. However, data on the effects of Ramadan fasting on hospital admissions and outcomes in patients with diabetes are scarce.OBJECTIVESEvaluate the characteristics of patients with diabetes admitted during the fasting month of Ramadan compared with the non-fasting month of Dhu al-Qidah.DESIGNA retrospective cohort study medical record review.SETTINGA university teaching hospital.PATIENTS AND METHODSWe reviewed the records of all patients with diabetes admitted to the medical department at Benghazi Medical Center, including medical ward, intensive care unit and coronary care unit, during the months of Ramadan and Dhu al-Qidah, 2016. We compared differences in reasons for admission, length of stay and in-hospital mortality between patients admitted during Ramadan and Dhu al-Qidah and between patients who were fasting at time of admission during Ramadan and those who were not.MAIN OUTCOME MEASURESMain reason for admission, length of stay and in-hospital mortality rate.SAMPLE SIZE402 patients with diabetes.RESULTSDuring Ramadan, 186 patients were admitted compared with 216 during Dhul al-Qidah. There was no statistically significant difference in reasons for admission, length of hospital stay, or in-hospital mortality (borderline for mortality, P=.078), between patients with diabetes admitted during Ramadan and Dhu al-Qidah. Of those admitted in Ramadan, 59.1% were fasting on admission. Fasting patients admitted during Ramadan had a significantly higher proportion of the diseases of the circulatory system when compared with non-fasting patients (39.4% vs. 23.6%, P=.028) while in-hospital mortality was higher in non-fasting patients (29.2% vs. 8.7%, P<.001). There was no significant difference in length of stay between fasting and non-fasting patients.CONCLUSIONSThe frequency of admissions for most medical conditions were not changed during Ramadan but the frequency of acute coronary syndrome was higher in those who were fasting on admission. Patients with diabetes who were not fasting on admission had more high-risk features that prevented them from fasting and therefore are at increased risk of in-hospital mortality.LIMITATIONSSingle center and retrospective.

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Section: Discussionmentioning

confidence: 76%

Outcomes and hospital admission patterns in patients with diabetes during Ramadan versus a non-fasting period

Elbarsha

Elhemri

Lawgaly

et al. 2018

Annals of Saudi Medicine

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“…Furthermore, the high-and very high-risk categories are heterogeneous groups including patients with different conditions and unmatched baseline characteristics which might have different impacts on fasting outcomes; therefore, the future studies must include patients with selected conditions and matched baseline characteristics. [15] Conclusions Patients in the high-risk category are significantly more likely to breakfasting during Ramadan than those in the low-risk category. Hypoglycemia is significantly higher in the high-risk group.…”

Section: Discussionmentioning

confidence: 96%

Comparison between high- and low-risk diabetic patients who fast Ramadan: A prospective cohort study

Elbarsha

Elhemri

Elmehdawi

2020

Ibnosina Journal of Medicine and Biomedical Sciences

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Objectives: The aim of this study is to compare the low-risk patients with the high- and very high-risk patients who choose to fast during Ramadan regarding the rates of breakfasting, hypoglycemia, hyperglycemia, hospitalization, and death. Patients and Methods: This is an observational, analytic, 1-month prospective, cohort study that involved patients with diabetes mellitus who choose to fast during the month of Ramadan in the Muslim year 1437. The patients were divided into two cohorts: Cohort 1 (high-risk) consisted of 83 patients who were categorized as high/very high-risk according to the International Diabetes Federation–Diabetes and Ramadan International Alliance guidelines on diabetes and Ramadan and Cohort 2 (low-risk) consisted of 65 patients categorized as moderate/low risk. Results: The overall of whole month fasting rate was 88% (100% in the low-risk group and 79% in the high-risk group, P = 0.000), and the rate of hypoglycemia was 12% (20.9% in the high-risk group vs. 0% in the low-risk group, P = 0.002). The rate of severe hyperglycemia was 7.7% (13.5% in the high-risk group vs. 0% in the low-risk group, P = 0.14). Conclusions: Patients in the high-risk category were significantly more likely to breakfasting during Ramadan than those in the low-risk category. Hypoglycemia was significantly higher in the high-risk group. The rates of severe hyperglycemia, hospitalization, and presumed mortality were not significantly higher in the high-risk group.

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“…In another study, feasibility of fasting was examined in adult patients with T1DM. [20] Patients aged 18 years or older with T1DM who chose to fast during Ramadan. They were interviewed during their first visit after Ramadan, and their records were reviewed for the number of days in which patients broke the fast, frequency of hypoglycemia, hyperglycemia, DKA, and any hospitalization during Ramadan.…”

Section: Attitudes and Feasibilitymentioning

confidence: 99%

The year in ramadan fasting research (2017): A narrative review

Beshyah

Hajjaji

Ibrahim

et al. 2018

Ibnosina Journal of Medicine and Biomedical Sciences

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Ramadan fasting is one of the five Pillars of Islam. While there are several exemptions from fasting, many Muslims with medical conditions still choose to fast. This may adversely affect their health if not addressed properly. Recently, there has been an increased interest in the health implications of Ramadan fasting. The authors performed a narrative, nonsystematic review of the literature including case reports, case series, and review articles indexed in PubMed and Google Scholar in a full calendar year. All records were reviewed by two coauthors at least. Studies were reviewed, summarized, and represented to provide a readily comprehensible concise account of the contributions made to research and clinical practice in 1 year (January–December 2017). The publications spanned physiological and clinical aspects and crossed conventional disciplinary lines in various languages, locations, and systems of journal access. A total of 92 and 82 were found in the PubMed and Google Scholar databases, respectively. Diabetes, hypoglycemia, insulin, and body composition were among the most relevant issues addressed this year. Discipline wise, diabetes, physiology, gastrointestinal, cardiovascular, eyes, respiratory, nephrology, neuropsychiatry, and endocrinology were most prominent. Other articles have considered professional competence, education, ethics, culture, and organization of care. Many of the research groups are based in emerging countries with Muslim-majority, but the publications are still widely distributed in internationally recognized journals. Several workers seem to have Ramadan fast at the center of their academic interest inferred from the number of publications to which they have contributed. The authors hope this review will help direct further research and should inform clinical practice guidance.

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Feasibility of Ramadan fasting in adults with type 1 diabetes: an observational study

Cited by 3 publications

References 8 publications

Outcomes and hospital admission patterns in patients with diabetes during Ramadan versus a non-fasting period

Outcomes and hospital admission patterns in patients with diabetes during Ramadan versus a non-fasting period

Comparison between high- and low-risk diabetic patients who fast Ramadan: A prospective cohort study

The year in ramadan fasting research (2017): A narrative review

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