Salem A Beshyah1, Mohamed Hassanein2, M Yakoob Ahmedani3, Shehla Shaikh4, Ebtesam M Ba-Essa5, Magdy H Megallaa6, Bachar Afandi7, Fawzi Ibrahim2, Talal Al-Muzaffar8. 1. Division of Endocrinology, Institute of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates. Electronic address: beshyah@yahoo.com. 2. Diabetes and Endocrinology Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates. 3. Baqai Institute of Diabetology & Endocrinology, Baqai Medical University, Karachi, Pakistan. 4. K G N Diabetes & Endocrinology Centre, Mumbai, India. 5. Diabetes and Endocrine Center, Dammam Medical Complex, Dammam, Saudi Arabia. 6. Unit of Diabetes & Metabolism, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt. 7. Department of Diabetes and Endocrinology, Tawam Hospital, Al Ain, United Arab Emirates; Department of Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. 8. Diabetes Unit, Amiri Hospital, Ministry of Health, Kuwait City, Kuwait.
Abstract
OBJECTIVES: To describe the risk of hypoglycaemia during Ramadan and determine its risk factors, and the impact of hypoglycaemia on patients' behaviour. METHODS: A cross-sectional multi-country observational study, with data captured within 6 weeks after Ramadan 2015. Patients' and disease characteristics and its management, the risk of hypoglycaemia and patients' response to hypoglycaemia were recorded. RESULTS: A cohort of 1759 patients; majority with type 2 diabetes mellitus from North Africa, Arabian Gulf, Saudi Arabia, and the Indian subcontinent. Hypoglycaemia was reported by 290 patients (16.8%); particularly affecting type 1 diabetes patients and in insulin-treated patients in general. Age was significantly younger in the hypoglycaemia group (P < 0.001). The commonest responses were reducing the dose or frequency of medications (42%), attending primary care providers (24.5%) or increasing monitoring (20.7%). Fasting was interrupted by 67% only of those who experienced hypoglycaemia and recourse to emergency services was pursued by less than a quarter of patients with hypoglycaemia. The country-wise analysis of the rates of hypoglycaemia was greatest in Egypt (51.3%) and lowest in Pakistan (3.5%). CONCLUSIONS: Hypoglycaemia is a significant complication of fasting during Ramadan. It may be predicted by type of diabetes, and use of insulin. Patients' responses are varied and call for more formal pre-Ramadan education.
OBJECTIVES: To describe the risk of hypoglycaemia during Ramadan and determine its risk factors, and the impact of hypoglycaemia on patients' behaviour. METHODS: A cross-sectional multi-country observational study, with data captured within 6 weeks after Ramadan 2015. Patients' and disease characteristics and its management, the risk of hypoglycaemia and patients' response to hypoglycaemia were recorded. RESULTS: A cohort of 1759 patients; majority with type 2 diabetes mellitus from North Africa, Arabian Gulf, Saudi Arabia, and the Indian subcontinent. Hypoglycaemia was reported by 290 patients (16.8%); particularly affecting type 1 diabetespatients and in insulin-treated patients in general. Age was significantly younger in the hypoglycaemia group (P < 0.001). The commonest responses were reducing the dose or frequency of medications (42%), attending primary care providers (24.5%) or increasing monitoring (20.7%). Fasting was interrupted by 67% only of those who experienced hypoglycaemia and recourse to emergency services was pursued by less than a quarter of patients with hypoglycaemia. The country-wise analysis of the rates of hypoglycaemia was greatest in Egypt (51.3%) and lowest in Pakistan (3.5%). CONCLUSIONS: Hypoglycaemia is a significant complication of fasting during Ramadan. It may be predicted by type of diabetes, and use of insulin. Patients' responses are varied and call for more formal pre-Ramadan education.
Authors: Dana Abdelrahim; MoezAlIslam E Faris; Mohamed Hassanein; Ayman Z Shakir; Ayesha M Yusuf; Aljohara S Almeneessier; Ahmed S BaHammam Journal: Front Endocrinol (Lausanne) Date: 2021-03-08 Impact factor: 5.555