Research Article
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The Effect of Fasting During Ramadan on Acute Metabolic Complications of Diabetes

Year 2025, Volume: 7 Issue: 1, 68 - 74, 15.01.2025
https://doi.org/10.37990/medr.1588373

Abstract

Aim: Ramadan fasting involves abstaining from eating and drinking from dawn to sunset for 29–30 days, causing significant lifestyle changes. These changes can increase the risk of acute metabolic complications in individuals with diabetes. This study investigates the impact of fasting during Ramadan on the frequency and clinical course of such complications.
Material and Method: This retrospective cross-sectional study included diabetic patients aged 18 years or older who presented to the emergency department (ED) of a tertiary care hospital between 2020 and 2024. Patients were grouped as fasting (≥10 days during Ramadan) or non-fasting. Key diagnoses included diabetic ketoacidosis (DKA), hyperglycemia, and hypoglycemia.
Results: Of the 229 patients (mean age 57.8 years; 56.3% female), 114 were in the fasting group. Both groups were predominantly diagnosed with Type 2 diabetes (85.1% vs. 86.1%). Hypoglycemia accounted for 42.1% of admissions in the fasting group, whereas hyperglycemia was predominant (93%) in the non-fasting group (p<0.001). No significant differences were found in in-hospital mortality or mechanical ventilation needs. However, fasting was associated with lower blood glucose levels in Type 2 diabetes patients (p<0.001).
Conclusion: Pre-fasting education is essential for effective diabetes management during Ramadan. Continuous education programs supported by updated evidence-based guidelines can mitigate risks and improve outcomes for fasting diabetic patients.

References

  • Türkiye Endokrinoloji ve Metabolizma Derneği. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve Izlem Kılavuzu 2022. 15th edition, BAYT Bilimsel Araştırmalar, Ankara ,2022.
  • Diabetes. https://www.who.int/health-topics/diabetes#tab=tab_1 access date 17.08.2024.
  • American Diabetes Association Professional Practice Committee. 3. Prevention or delay of diabetes and associated comorbidities: standards of care in diabetes-2024. Diabetes Care. 2024;47:S43-51.
  • Hassanein M, Afandi B, Yakoob Ahmedani M, et al. Diabetes and Ramadan: Practical guidelines 2021. Diabetes Res Clin Pract. 2022;185:109185.
  • Seyit M, Yilmaz A, Aykota MR, Ozen M. Does the frequency of acute pancreatitis decrease in Ramadan?. Pamukkale Med J. 2021;14:141-53.
  • Ahmed SH, Chowdhury TA, Hussain S, et al. Ramadan and diabetes: a narrative review and practice update. Diabetes Ther. 2020;11:2477-520.
  • Hassanein M, Al-Arouj M, Hamdy O, et al. Diabetes and Ramadan: practical guidelines. Diabetes Res Clin Pract. 2017;126:303-16.
  • Bener A, Yousafzai MT. Effect of Ramadan fasting on diabetes mellitus. J Egypt Public Health Assoc. 2014;89:47-52.
  • Aladağ N, Akin S, Özgür Y, et al. The effect of self glucose monitoring on glycemic control of patients with diabetes mellitus fasting during Ramadan. Acta Medica Alanya. 2022;6:27-33.
  • Onur A, Caferoğlu Z, Hati̇poğlu N. Management of diabetes in individuals with diabetes who are fasting during Ramadan. Turkish J Diabetes Obes. 2021;5:59-67.
  • Salti I, Bénard E, Detournay B, et al. A Population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries. Diabetes Care. 2004;27:2306-11.
  • Antar SA, Ashour NA, Sharaky M, et al. Diabetes mellitus: Classification, mediators, and complications; a gate to identify potential targets for the development of new effective treatments. Biomed Pharmacother. 2023;168:115734.
  • Al-Arouj M, Bouguerra R, Buse J, et al. Recommendations for management of diabetes during Ramadan. Diabetes Care. 2005;28:2305-11.
  • Perk G, Ghanem J, Aamar S, et al. The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives. J Hum Hypertens. 2001;15:723-5.
  • Beshyah SA, Chowdhury TA, Ghouri N, Lakhdar AA. Risk of diabetic ketoacidosis during Ramadan fasting: a critical reappraisal. Diabetes Res Clin Pract. 2019;151:290-8.
Year 2025, Volume: 7 Issue: 1, 68 - 74, 15.01.2025
https://doi.org/10.37990/medr.1588373

Abstract

References

  • Türkiye Endokrinoloji ve Metabolizma Derneği. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve Izlem Kılavuzu 2022. 15th edition, BAYT Bilimsel Araştırmalar, Ankara ,2022.
  • Diabetes. https://www.who.int/health-topics/diabetes#tab=tab_1 access date 17.08.2024.
  • American Diabetes Association Professional Practice Committee. 3. Prevention or delay of diabetes and associated comorbidities: standards of care in diabetes-2024. Diabetes Care. 2024;47:S43-51.
  • Hassanein M, Afandi B, Yakoob Ahmedani M, et al. Diabetes and Ramadan: Practical guidelines 2021. Diabetes Res Clin Pract. 2022;185:109185.
  • Seyit M, Yilmaz A, Aykota MR, Ozen M. Does the frequency of acute pancreatitis decrease in Ramadan?. Pamukkale Med J. 2021;14:141-53.
  • Ahmed SH, Chowdhury TA, Hussain S, et al. Ramadan and diabetes: a narrative review and practice update. Diabetes Ther. 2020;11:2477-520.
  • Hassanein M, Al-Arouj M, Hamdy O, et al. Diabetes and Ramadan: practical guidelines. Diabetes Res Clin Pract. 2017;126:303-16.
  • Bener A, Yousafzai MT. Effect of Ramadan fasting on diabetes mellitus. J Egypt Public Health Assoc. 2014;89:47-52.
  • Aladağ N, Akin S, Özgür Y, et al. The effect of self glucose monitoring on glycemic control of patients with diabetes mellitus fasting during Ramadan. Acta Medica Alanya. 2022;6:27-33.
  • Onur A, Caferoğlu Z, Hati̇poğlu N. Management of diabetes in individuals with diabetes who are fasting during Ramadan. Turkish J Diabetes Obes. 2021;5:59-67.
  • Salti I, Bénard E, Detournay B, et al. A Population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries. Diabetes Care. 2004;27:2306-11.
  • Antar SA, Ashour NA, Sharaky M, et al. Diabetes mellitus: Classification, mediators, and complications; a gate to identify potential targets for the development of new effective treatments. Biomed Pharmacother. 2023;168:115734.
  • Al-Arouj M, Bouguerra R, Buse J, et al. Recommendations for management of diabetes during Ramadan. Diabetes Care. 2005;28:2305-11.
  • Perk G, Ghanem J, Aamar S, et al. The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives. J Hum Hypertens. 2001;15:723-5.
  • Beshyah SA, Chowdhury TA, Ghouri N, Lakhdar AA. Risk of diabetic ketoacidosis during Ramadan fasting: a critical reappraisal. Diabetes Res Clin Pract. 2019;151:290-8.
There are 15 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Original Articles
Authors

Muhammet Ali Erinmez 0000-0003-2229-2385

Mehmet Seyfettin Sarıbaş 0000-0002-2037-0522

Fırat Güneş 0009-0008-1672-9812

Ece Oğuz 0000-0001-6586-7236

Publication Date January 15, 2025
Submission Date November 20, 2024
Acceptance Date December 9, 2024
Published in Issue Year 2025 Volume: 7 Issue: 1

Cite

AMA Erinmez MA, Sarıbaş MS, Güneş F, Oğuz E. The Effect of Fasting During Ramadan on Acute Metabolic Complications of Diabetes. Med Records. January 2025;7(1):68-74. doi:10.37990/medr.1588373

17741

Chief Editors

Assoc. Prof. Zülal Öner
İzmir Bakırçay University, Department of Anatomy, İzmir, Türkiye

Assoc. Prof. Deniz Şenol
Düzce University, Department of Anatomy, Düzce, Türkiye

Editors
Assoc. Prof. Serkan Öner
İzmir Bakırçay University, Department of Radiology, İzmir, Türkiye
 
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