An update on the current characteristics and status of care for Muslims with type 2 diabetes fasting during Ramadan: The DAR global survey 2022

Abstract

ABSTRACT Background Managing diabetes during Ramadan fasting is a challenge due lifestyle changes. We describe the characteristics and patterns of care for type 2 diabetes mellitus (T2DM) during Ramadan 2020 and 2022. Methods Our study included multinational Muslims with T2DM who were during routine consultation. We collected data on demographics, fasting characteristics, and complications. Descriptive statistics, Chi square test and multiple testing were performed. Results 12,529 patients participated. Mean age was 55.2 ± 11.8 years; 52.4% were females. Mean diabetes duration was 9.9 ± 7.4 years; 27.7% were with HbA1c > 9% (75 mmol/mol) and 70% with complications. Metformin was the most used followed by insulin. 85.1% fasted ≥ 1 day; fasting mean duration was 27.6 ± 5.6 days. Hypoglycemia occurred in 15.5% of whom 11.7% attended emergency department or were hospitalized; this was significantly associated with age and/or duration of diabetes. Hyperglycemia occurred in 14.9% and was also associated with age or diabetes duration. 6.1% attended emergency department or were hospitalized. 74.2% performed SMBG during fasting. 59.2% were educated on Ramadan fasting, with 89.7% receiving it during routine consultation. Conclusions Ramadan fasting in T2DM is high. Multidisciplinary approach is required to mitigate complications. Our findings support current recommendations for safe fasting.