From the Medical College (Alfadhli, Alharbi, Alrotoie, Asia Aljohani, Qari, Alsubhi, Alsaedi), Taibah University, from the Department of Internal Medicine (Alfadhli), King Faisal Specialist Hospital and Research Center, and from the Diabetes Center (Alaa Aljohani), King Salman Bin Abdulaziz Medical City, Al-Madinah Al-Munawarah, Kingdom of Saudi Arabia.
Saudi Med J. 2024 Jan;45(1):86-92. doi: 10.15537/smj.2024.45.1.2023060.
To assess the validity of the new International Diabetes Federation-Diabetes and Ramadan International Alliance (IDF-DAR) risk stratification tool for Ramadan fasting in predicting diabetic patients' ability to fast safely.
A prospective observational study was carried out during Ramadan 2022 at the Diabetes Center, King Fahad Hospital, Al-Madinah Al-Munawarah, Saudi Arabia. The IDF-DAR risk stratification tool was used to calculate fasting risk for diabetic patients pre-Ramadan. The patients were allocated into 3 categories: high, moderate, and low risk. Fasting was left up to the patients and their healthcare providers. Participants filled out a log-sheet each day of Ramadan showing whether they completed the fast. A final interview was carried out after Ramadan to assess patients' fasting experiences.
We included 466 patients with diabetes: 79.4% with T2DM and 20.6% with T1DM. Based on the IDF-DAR score, 265 (56.9%) patients were classified as high risk, 115 (24.7%) as moderate risk, and 86 (18.4%) as low risk. Non-fasting the whole month of Ramadan was statistically relevant to the IDF-DAR risk stratification score. High-risk individuals were more likely to experience hypoglycemia and hyperglycemia than those with a moderate or low risk. But overall, 70.4% of people at moderate risk and 53.2% of the ones at high risk observed Ramadan's complete fast.
The IDF-DAR has proven to be reliable and valid for predicting the risk of adverse events associated with fasting in diabetic patients. Nonetheless, it might overestimate the risk of fasting for some patients.
评估新的国际糖尿病联合会-糖尿病与斋月国际联盟（IDF-DAR）风险分层工具在预测糖尿病患者安全斋戒能力方面的有效性。
在沙特阿拉伯麦地那的法赫德国王医院糖尿病中心进行了一项前瞻性观察研究，在 2022 年斋月期间进行。在斋月前，使用 IDF-DAR 风险分层工具计算糖尿病患者的斋戒风险。将患者分为高、中、低风险三类。斋戒由患者及其医疗保健提供者决定。参与者在斋月期间每天填写日志表，记录是否完成斋戒。在斋月结束后进行最终访谈，以评估患者的斋戒体验。
我们纳入了 466 名糖尿病患者：79.4%为 2 型糖尿病，20.6%为 1 型糖尿病。根据 IDF-DAR 评分，265 名（56.9%）患者被归类为高风险，115 名（24.7%）为中风险，86 名（18.4%）为低风险。整个斋月不斋戒与 IDF-DAR 风险分层评分有统计学相关性。高风险个体比中风险或低风险个体更有可能出现低血糖和高血糖。但总体而言，70.4%的中风险患者和 53.2%的高风险患者完成了整个斋月的斋戒。
IDF-DAR 已被证明可靠且有效，可预测与糖尿病患者斋戒相关的不良事件风险。然而，它可能会高估某些患者的斋戒风险。
