Title:Risk Stratification in People with Diabetes for Fasting During Ramadan:
Consensus from Arabic Association for the Study of Diabetes and
Metabolism
Volume: 20
Issue: 7
Author(s): Inass Shaltout*, Amr Mahmoud Abdelwahab, Amr El Meligi, Hany Hammad, Shereen Abdelghaffar, Atef Elbahry, Nasser Taha, Nehal Hamdy Elsaid, Amr Gad, Laila Hammouda, Shaymaa Abdelmaboud and Amin Roshdy Soliman
Affiliation:
- Internal Medicine and Diabetes Department, Cairo University, Cairo, Egypt
Keywords:
Diabetes, type 2 diabetes, type 1 diabetes, fasting, ramadan, risk stratification.
Abstract:
Background: Current international guidelines recommend a pre-Ramadan risk assessment
for people with diabetes (PwDM) who plan on fasting during the Holy month. However,
a comprehensive risk assessment-based recommendation for the management of PwDM intending
to fast is still controversial. Therefore, the Arabic Association for the Study of Diabetes
and Metabolism (AASD) developed this consensus to provide further insights into risk stratification
in PwDM intending to fast during Ramadan.
Methods: The present consensus was based on the three-step modified Delphi method. The
modified Delphi method is based on a series of voting rounds and in-between meetings of the
expert panel to reach agreements on the statements that did not reach the consensus level during
voting. The panel group comprised professors and consultants in endocrinology (both adult and
pediatric). Other members included experts in the fields of cardiovascular medicine, nephrology,
ophthalmology, and vascular surgery, affiliated with academic institutions in Egypt.
Result: In PwDM who intend to fast during Ramadan, risk stratification is crucial to optimize
patient outcomes and prevent serious complications. The present consensus provides risk assessment
of those living with diabetes according to several factors, including the type of diabetes,
presence, and severity of complications, number of fasting hours, and other socioeconomic
factors. According to their risk factors, patients were classified into four categories (very high,
high, moderate, and low risk).
Conclusion: Future research is warranted due to the controversial literature regarding the impact
of fasting on certain comorbidities.
