Diabetes emergencies around Ramadan study (DEARS) – A multi-center study of diabetes emergencies admitted before, during and after Ramadan in Malaysia

Tong, Chin Voon; Yow, Hui-Yin; Noor, Nurain Mohd; Hussein, Zanariah

doi:10.1016/j.diabres.2021.108854

Cited by 6 publications

(6 citation statements)

References 12 publications

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“…Additionally, the admissions for diabetes emergencies among 295 patients who fasted or planned to fast 1 month before ( N = 119), during ( N = 106), and 1 month after ( N = 70) Ramadan of 2019 in public hospitals in Malaysia were investigated. 30 Admissions for hyperglycemic emergencies accounted for two-thirds of admissions. Thirty-seven percent of admissions for hypoglycemia occurred before Ramadan and 32.1% during Ramadan.…”

Section: Resultsmentioning

confidence: 99%

Burden and Patterns of Medical Emergencies during Ramadan Fasting: A Narrative Review

Beshyah

Elamouri

Almagdub

et al. 2023

Ibnosina Journal of Medicine and Biomedical Sciences

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Introduction Acute medical problems may occur more frequently during Ramadan fasting (RF). We aimed to provide a narrative overview of the global literature on medical emergencies during RF. Methods This is a nonsystematic review of the international literature from one major medical online database (PubMed, National Institutes of Health, United States). The relevant literature was narrated in a concise thematic account. Results There is a variable impact in the burden and time distribution of emergency services and hospitalization during RF that may require readjustment of resource allocation. Studies of the risk of accidents and injuries may be increased overall or at specified times, around Iftar time. A classical impact of emergencies has been the risk of worsening peptic ulcer disease. RF impacts diabetic emergencies such as severe hypoglycemia, hyperglycemia, and diabetic ketoacidosis, particularly in type 1 diabetes and poorly controlled patients. Glucocorticoid replacement therapy may represent a challenge to patients and physicians that require education and dose adjustment. Acute neurological conditions of interest include the “first day of Ramadan headache,” epilepsy, and strokes. Several studies evaluated the risk of the acute coronary syndrome and heart failure with inconsistent findings. RF may impact the renal and urological systems through stone disease, renal colic, and acute kidney. The impact on hematological conditions was mostly focused on the safety of anticoagulant therapy during Ramadan. Conclusion The review addresses the emergency medical encounters of the fasting patient during Ramadan to allow a holistic and ethnically sensitive approach to medical care under circumstances where decisions have to be taken with no delay.

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Section: Resultsmentioning

confidence: 99%

Burden and Patterns of Medical Emergencies during Ramadan Fasting: A Narrative Review

Beshyah

Elamouri

Almagdub

et al. 2023

Ibnosina Journal of Medicine and Biomedical Sciences

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“…The study concluded that non-compliance was the main factor causing the increase in the number during Ramadan. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

Incidence of diabetic ketoacidosis during Ramadan compared with non-fasting months in King Saud Medical City, Riyadh, Saudi Arabia

Alshahrani

Alraddadi

2022

Journal of Family Medicine and Primary Care

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Background: Ramadan in Islam is the ninth month of the Muslim calendar and the holy month of fasting. In the fasting state, there is the danger of the blood glucose levels becoming too high when normal levels of medication are not taken. This can lead to diabetic ketoacidosis (DKA). The risk of diabetic emergencies, including DKA, is thought to be higher during Ramadan fasting due to metabolic changes and alterations in food habits. We aim to assess the incidence of DKA during Ramadan and perform a comparison pre and post month of Ramadan. Methods: This is a retrospective study that involves all adults who were admitted with DKA to King Saud Medical City in Riyadh, Saudi Arabia. We explored the relationship of admissions to Ramadan and compared it to the month before (Sha’aban) and the month after (Shawwal). Results: During the duration of the study, 51 patients with DKA were admitted to the hospital. Nineteen patients in Ramadan (37.3%), eight patients in Sha’aban (15.7%), and 24 patients in Shawwal (47%). This shows a significant increment in Ramadan compared to Sha’aban, and more increment in Shawwal ( P = 0.019). The most common precipitating factor for diabetic ketoacidosis during Ramadan and Sha’aban is missing insulin dose, while infections are considered the main stimulating agent in Shawwal. Conclusion: There was an increase in the incidence of DKA episodes in Ramadan compared with the preceding month, but fewer DKA events compared to Shawwal, which might indicate that Ramadan fasting is a potential risk factor for DKA.

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“…The first systematic review and meta-analysis evaluated the safety and efficacy of the newer glucose-lowering therapies on diabetic control, weight, blood pressure, and hypoglycemia in patients with T2DM during Ramadan. 19 A total of 20 studies were included. Dipeptidyl peptidase-4 inhibitors (DPP-4i) resulted in a significant reduction in HbA1c and a nonsignificant decrease in weight during Ramadan.…”

Section: Highlights Of the Literaturementioning

confidence: 99%

“…Hyperglycemia among T2DM and insulin-treated patients has recorded the highest feature of diabetes emergencies visits during the 3 months studied with no significant differences between the months. Also, Tong CV et al 19 determined admissions for diabetes emergencies among patients who fasted or planned to fast 1 month before, during, and 1 month after Ramadan 2019 in public hospitals in Malaysia. They conducted a prospective cross-sectional study in 18 public hospitals in Malaysia from April 7, 2019, to July 2, 2019.…”

Section: Diabetic Emergenciesmentioning

confidence: 99%

Ramadan Fasting and Diabetes (2021): The Year in Review

Beshyah

Hafidh

Kenz

et al. 2022

Journal of Diabetes and Endocrine Practice

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Introduction The literature on the impact of Ramadan fasting (RF) on diabetes is widely spread in many journals. This makes it not readily accessible to those interested in the subject. We aimed to provide a narrative overview of the global literature production in 1 year (2021) on diabetes and RF. Materials and Methods This was a narrative, nonsystematic review of the international literature from a single major medical online database (i.e., PubMed) during the year 2021. The search term “Ramadan fasting AND Diabetes” was used, and the relevant literature was narrated in a concise thematic account. Results The publications spanned a vast array of topics related to diabetes and RF, including epidemiology, assessments of safety and efficacy profiles of older and newer diabetes therapies, hypoglycemia, diabetes education, use of advanced technology for the treatment, and monitoring and impact on pregnancy. Some reports covered the interaction of Ramadan and the novel coronavirus disease 2019 (COVID-19) in relationship to diabetes. Professional concerns, patients' perspectives, and telemedicine's role in RF were also addressed. Conclusion The current narration presents this year's literature on the safety of fasting practices, care models, and patients' experiences and perspectives. Work should continue on comprehensive assessments for the interplay of diabetes and RF under different settings. Particular attention should focus on the roles of newer antidiabetic medicines and advanced technology for safer fasting practices.

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Diabetes emergencies around Ramadan study (DEARS) – A multi-center study of diabetes emergencies admitted before, during and after Ramadan in Malaysia

Cited by 6 publications

References 12 publications

Burden and Patterns of Medical Emergencies during Ramadan Fasting: A Narrative Review

Burden and Patterns of Medical Emergencies during Ramadan Fasting: A Narrative Review

Incidence of diabetic ketoacidosis during Ramadan compared with non-fasting months in King Saud Medical City, Riyadh, Saudi Arabia

Ramadan Fasting and Diabetes (2021): The Year in Review

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