Risk Stratification in People with Diabetes for Fasting During Ramadan: Consensus from Arabic Association for the Study of Diabetes and Metabolism


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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.

About the authors

Inass Shaltout

Internal Medicine and Diabetes Department, Cairo University, Cairo, Egypt

Author for correspondence.
Email: info@benthamscience.net

Shaymaa Abdelmaboud

Cardiology Department, National Heart Institute, Giza, Egypt

Email: info@benthamscience.net

Laila Hammouda

Ophthalmology Department, Minia University, Minia,
Egypt

Email: info@benthamscience.net

Amr Gad

Vascular Surgery Department, Cairo University, Cairo, Egypt

Email: info@benthamscience.net

Nehal Elsaid

Internal Medicine and Diabetes Department, Cairo University, Cairo, Egypt; Arabic Association for the Study of Diabetes and Metabolism (AASD)

Email: info@benthamscience.net

Nasser Taha

Cardiology Department, Minia University, Minia, Egypt

Email: info@benthamscience.net

Atef Elbahry

Cardiology Unit, Port Fouad Centre, Port Fouad, Egypt

Email: info@benthamscience.net

Shereen Abdelghaffar

Department of Pediatrics, Pediatric Diabetes and Endocrinology Unit, Cairo University, Cairo, Egypt

Email: info@benthamscience.net

Hany Hammad

Internal Medicine and Nephrology Department, Cairo University, Cairo,
Egypt

Email: info@benthamscience.net

Amr El Meligi

Internal Medicine and Diabetes Department, Cairo University, Cairo, Egypt

Email: info@benthamscience.net

Amr Abdelwahab

Internal Medicine and Diabetes Department,
Minia University, Minia, Egypt

Email: info@benthamscience.net

Amin Soliman

Internal Medicine and Nephrology Department, Cairo University, Cairo,
Egypt

Email: info@benthamscience.net

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