Consultant Diabetologist and Endocrinologist, Bolan Medical Complex Hospital (B.M.C.H), Quetta, Pakistan.
Professor of Medicine, Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan.
Diabetes Res Clin Pract. 2022 Mar;185:109234. doi: 10.1016/j.diabres.2022.109234. Epub 2022 Feb 4.
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.
确定 IDF-DAR 风险类别下的糖尿病患者在斋月禁食期间发生主要并发症的循证风险因素。
这项前瞻性观察性多中心研究由 Baqai 内分泌糖尿病研究所（BIDE）于 2019 年 4 月至 6 月进行。有意愿在斋月期间禁食的糖尿病患者被招募。在斋月前访问期间进行人口统计学数据收集和风险分类。对每位研究参与者进行一对一的结构化教育。在斋月后访问期间评估并发症。
共有 1045 名糖尿病患者参与，性别分布几乎相等。三分之二的研究人群被归入极高和高风险类别。主要低血糖、高血糖、住院和需要打破斋戒的发生率分别为 4.4%、10.8%、0.8%和 3.1%。多变量分析发现，斋月期间发生主要低血糖的风险因素为男性、使用镇静剂和抗抑郁药以及患有 1 型糖尿病、过去 3 个月内有 DKA/HHS 史，而主要高血糖、主要低血糖和打破斋戒需要住院的风险因素为年龄较大、急性疾病和主要低血糖。
在这项前瞻性研究中，确定了糖尿病患者与斋戒相关的主要并发症的循证风险因素。在斋月前风险评估访问期间识别这些因素至关重要。
