An update on the current characteristics and status of care for Muslims with type 2 diabetes fasting during Ramadan: The DAR global survey 2022

ABSTRACT

Background

Managing diabetes during Ramadan fasting is a challenge due lifestyle changes. We describe the characteristics and patterns of care for type 2 diabetes mellitus (T2DM) during Ramadan 2020 and 2022.

Methods

Our study included multinational Muslims with T2DM who were during routine consultation. We collected data on demographics, fasting characteristics, and complications. Descriptive statistics, Chi square test and multiple testing were performed.

Results

12,529 patients participated. Mean age was 55.2 ± 11.8 years; 52.4% were females. Mean diabetes duration was 9.9 ± 7.4 years; 27.7% were with HbA1c > 9% (75 mmol/mol) and 70% with complications. Metformin was the most used followed by insulin. 85.1% fasted ≥ 1 day; fasting mean duration was 27.6 ± 5.6 days. Hypoglycemia occurred in 15.5% of whom 11.7% attended emergency department or were hospitalized; this was significantly associated with age and/or duration of diabetes. Hyperglycemia occurred in 14.9% and was also associated with age or diabetes duration. 6.1% attended emergency department or were hospitalized. 74.2% performed SMBG during fasting. 59.2% were educated on Ramadan fasting, with 89.7% receiving it during routine consultation.

Conclusions

Ramadan fasting in T2DM is high. Multidisciplinary approach is required to mitigate complications. Our findings support current recommendations for safe fasting.

Plain language summary

The goal of this survey was to describe the characteristics and current ways of care for Muslim patients with type 2 diabetes mellitus fasting during and after Ramadan 2020 and 2022. Most of the participants fasted a minimum of one day during Ramadan (85.1%). Overall, 15.5% and 14.9% reported low blood sugar levels or high blood sugar levels during fasting, respectively. Low blood sugar level was more reported in patients with older age, patients with longer diabetes duration, and women. High blood sugar level was more reported in patients with longer diabetes duration. Educational programs focusing on the risks occurring with fasting and practices that improve control of the disease will raise knowledge and awareness among patients with diabetes. Improving blood sugar control during Ramadan fasting remains a major need for both patients and healthcare providers who should collaborate to reduce the risk of diabetes-related problems.

KEYWORDS:

• Fasting
• Ramadan
• type 2 diabetes
• survey
• multicenter

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Additional information

Funding

The authors retained the editorial process, including the discussion at all times. There was no financial reward associated with writing the paper. Phoenix Clinical Research provided editorial and medical writing assistance for the preparation of this manuscript based on the Good Publication Practice (GPP 2022) and the ICMJE requirements. Writing assistance was funded by Servier. The views and opinions expressed are those of the authors. Servier had no influence over the content of the paper.