Patterns of Diabetes Care Among People with Type 1 Diabetes During Ramadan: An International Prospective Study (DAR-MENA T1DM)

Fatheya F. Al Awadi; Akram Echtay; Monira Al Arouj; Sobia Sabir Ali; Naim Shehadeh; Abdulrahman Al Shaikh; Khier Djaballah; Cecile Dessapt-Baradez; Mohamad Omar Abu-Hijleh; Abdullah Bennakhi; Mohamed El Hassan Gharbi; Khaled El Sayed El Hadidy; Faris Abdul Kareem Khazaal; Mohamed M. Hassanein

doi:10.1007/s12325-020-01267-4

Patterns of Diabetes Care Among People with Type 1 Diabetes During Ramadan: An International Prospective Study (DAR-MENA T1DM)

Fatheya F. Al Awadi
, Akram Echtay
, Monira Al Arouj
, Sobia Sabir Ali
, Naim Shehadeh
, Abdulrahman Al Shaikh
, Khier Djaballah
, Cecile Dessapt-Baradez
, Mohamad Omar Abu-Hijleh
, Abdullah Bennakhi
, Mohamed El Hassan Gharbi
, Khaled El Sayed El Hadidy
, Faris Abdul Kareem Khazaal
, Mohamed M. Hassanein

Rafik Hariri University
Dasman Diabetes Institute
University of Peshawar
Rambam Health Care Campus Israel
King Abdulaziz University
Sanofi-Aventis
Sanofi
Jordan Hospital
Ibn Sina Hospital, Agdal Rabat
Beni-Suef University
Alkindy Obesity Center

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Introduction: To describe the characteristics and care of participants with type 1 diabetes during Ramadan in the Middle East and North Africa. Methods: The DAR-MENA (Diabetes and Ramadan—Middle East and North Africa) study was a prospective, observational study of adults with type 1 and type 2 diabetes who were Muslim and did/did not intend to fast during Ramadan 2016. Baseline data were collected 6 weeks prior to Ramadan, with a follow-up visit 1–2 months after Ramadan. This is the analysis of the population with type 1 diabetes. Measurements included proportion who fasted, reasons for fasting and not fasting, changes in diabetes treatment, hypoglycemic events, and proportion with access to diabetes education. Results: Of 136 participants with type 1 diabetes, 76.9% (100/130) fasted for at least 1 day, 72.3% (94/130) fasted for at least 15 days, and 48.5% (63/130) fasted for 30 days. The majority (63.0%, 63/100) reported personal decision as a reason to fast. Fear of diabetic complications (58.6%, 17/29) and previous complications related to fasting (48.3%, 14/29) were the most common reasons for not fasting. Adjustment of diabetic medication regimen occurred for 84.6% (115/136) of participants, and 72.8% (99/136) changed their treatment dose. The incidence and number of adverse events for confirmed and severe hypoglycemia were similar before and during Ramadan. Almost half of participants had access to diabetes education (45.6%, 62/136). Conclusion: The DAR-MENA study showed that despite the risks associated with fasting for people with type 1 diabetes, almost half fasted for the full 30 days of Ramadan with no significant change in hypoglycemia events. Since the current International Diabetes Federation and Diabetes and Ramadan guidelines do not endorse fasting for people with type 1 diabetes, it is important that those who insist on fasting work closely with their healthcare practitioner to avoid any complications.

Original language	English
Pages (from-to)	1550-1563
Number of pages	14
Journal	Advances in Therapy
Volume	37
Issue number	4
DOIs	https://doi.org/10.1007/s12325-020-01267-4
State	Published - 1 Apr 2020

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Epidemiology
Fasting
Hypoglycemia
Ramadan
Type 1 diabetes

Access to Document

10.1007/s12325-020-01267-4

Cite this

Al Awadi, F. F., Echtay, A., Al Arouj, M., Sabir Ali, S., Shehadeh, N., Al Shaikh, A., Djaballah, K., Dessapt-Baradez, C., Omar Abu-Hijleh, M., Bennakhi, A., El Hassan Gharbi, M., El Sayed El Hadidy, K., Abdul Kareem Khazaal, F., & Hassanein, M. M. (2020). Patterns of Diabetes Care Among People with Type 1 Diabetes During Ramadan: An International Prospective Study (DAR-MENA T1DM). Advances in Therapy, 37(4), 1550-1563. https://doi.org/10.1007/s12325-020-01267-4

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title = "Patterns of Diabetes Care Among People with Type 1 Diabetes During Ramadan: An International Prospective Study (DAR-MENA T1DM)",

abstract = "Introduction: To describe the characteristics and care of participants with type 1 diabetes during Ramadan in the Middle East and North Africa. Methods: The DAR-MENA (Diabetes and Ramadan—Middle East and North Africa) study was a prospective, observational study of adults with type 1 and type 2 diabetes who were Muslim and did/did not intend to fast during Ramadan 2016. Baseline data were collected 6 weeks prior to Ramadan, with a follow-up visit 1–2 months after Ramadan. This is the analysis of the population with type 1 diabetes. Measurements included proportion who fasted, reasons for fasting and not fasting, changes in diabetes treatment, hypoglycemic events, and proportion with access to diabetes education. Results: Of 136 participants with type 1 diabetes, 76.9\% (100/130) fasted for at least 1 day, 72.3\% (94/130) fasted for at least 15 days, and 48.5\% (63/130) fasted for 30 days. The majority (63.0\%, 63/100) reported personal decision as a reason to fast. Fear of diabetic complications (58.6\%, 17/29) and previous complications related to fasting (48.3\%, 14/29) were the most common reasons for not fasting. Adjustment of diabetic medication regimen occurred for 84.6\% (115/136) of participants, and 72.8\% (99/136) changed their treatment dose. The incidence and number of adverse events for confirmed and severe hypoglycemia were similar before and during Ramadan. Almost half of participants had access to diabetes education (45.6\%, 62/136). Conclusion: The DAR-MENA study showed that despite the risks associated with fasting for people with type 1 diabetes, almost half fasted for the full 30 days of Ramadan with no significant change in hypoglycemia events. Since the current International Diabetes Federation and Diabetes and Ramadan guidelines do not endorse fasting for people with type 1 diabetes, it is important that those who insist on fasting work closely with their healthcare practitioner to avoid any complications.",

keywords = "Epidemiology, Fasting, Hypoglycemia, Ramadan, Type 1 diabetes",

author = "\{Al Awadi\}, \{Fatheya F.\} and Akram Echtay and \{Al Arouj\}, Monira and \{Sabir Ali\}, Sobia and Naim Shehadeh and \{Al Shaikh\}, Abdulrahman and Khier Djaballah and Cecile Dessapt-Baradez and \{Omar Abu-Hijleh\}, Mohamad and Abdullah Bennakhi and \{El Hassan Gharbi\}, Mohamed and \{El Sayed El Hadidy\}, Khaled and \{Abdul Kareem Khazaal\}, Faris and Hassanein, \{Mohamed M.\}",

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year = "2020",

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doi = "10.1007/s12325-020-01267-4",

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Al Awadi, FF, Echtay, A, Al Arouj, M, Sabir Ali, S, Shehadeh, N, Al Shaikh, A, Djaballah, K, Dessapt-Baradez, C, Omar Abu-Hijleh, M, Bennakhi, A, El Hassan Gharbi, M, El Sayed El Hadidy, K, Abdul Kareem Khazaal, F & Hassanein, MM 2020, 'Patterns of Diabetes Care Among People with Type 1 Diabetes During Ramadan: An International Prospective Study (DAR-MENA T1DM)', Advances in Therapy, vol. 37, no. 4, pp. 1550-1563. https://doi.org/10.1007/s12325-020-01267-4

TY - JOUR

T1 - Patterns of Diabetes Care Among People with Type 1 Diabetes During Ramadan

T2 - An International Prospective Study (DAR-MENA T1DM)

AU - Al Awadi, Fatheya F.

AU - Echtay, Akram

AU - Al Arouj, Monira

AU - Sabir Ali, Sobia

AU - Shehadeh, Naim

AU - Al Shaikh, Abdulrahman

AU - Djaballah, Khier

AU - Dessapt-Baradez, Cecile

AU - Omar Abu-Hijleh, Mohamad

AU - Bennakhi, Abdullah

AU - El Hassan Gharbi, Mohamed

AU - El Sayed El Hadidy, Khaled

AU - Abdul Kareem Khazaal, Faris

AU - Hassanein, Mohamed M.

PY - 2020/4/1

Y1 - 2020/4/1

N2 - Introduction: To describe the characteristics and care of participants with type 1 diabetes during Ramadan in the Middle East and North Africa. Methods: The DAR-MENA (Diabetes and Ramadan—Middle East and North Africa) study was a prospective, observational study of adults with type 1 and type 2 diabetes who were Muslim and did/did not intend to fast during Ramadan 2016. Baseline data were collected 6 weeks prior to Ramadan, with a follow-up visit 1–2 months after Ramadan. This is the analysis of the population with type 1 diabetes. Measurements included proportion who fasted, reasons for fasting and not fasting, changes in diabetes treatment, hypoglycemic events, and proportion with access to diabetes education. Results: Of 136 participants with type 1 diabetes, 76.9% (100/130) fasted for at least 1 day, 72.3% (94/130) fasted for at least 15 days, and 48.5% (63/130) fasted for 30 days. The majority (63.0%, 63/100) reported personal decision as a reason to fast. Fear of diabetic complications (58.6%, 17/29) and previous complications related to fasting (48.3%, 14/29) were the most common reasons for not fasting. Adjustment of diabetic medication regimen occurred for 84.6% (115/136) of participants, and 72.8% (99/136) changed their treatment dose. The incidence and number of adverse events for confirmed and severe hypoglycemia were similar before and during Ramadan. Almost half of participants had access to diabetes education (45.6%, 62/136). Conclusion: The DAR-MENA study showed that despite the risks associated with fasting for people with type 1 diabetes, almost half fasted for the full 30 days of Ramadan with no significant change in hypoglycemia events. Since the current International Diabetes Federation and Diabetes and Ramadan guidelines do not endorse fasting for people with type 1 diabetes, it is important that those who insist on fasting work closely with their healthcare practitioner to avoid any complications.

AB - Introduction: To describe the characteristics and care of participants with type 1 diabetes during Ramadan in the Middle East and North Africa. Methods: The DAR-MENA (Diabetes and Ramadan—Middle East and North Africa) study was a prospective, observational study of adults with type 1 and type 2 diabetes who were Muslim and did/did not intend to fast during Ramadan 2016. Baseline data were collected 6 weeks prior to Ramadan, with a follow-up visit 1–2 months after Ramadan. This is the analysis of the population with type 1 diabetes. Measurements included proportion who fasted, reasons for fasting and not fasting, changes in diabetes treatment, hypoglycemic events, and proportion with access to diabetes education. Results: Of 136 participants with type 1 diabetes, 76.9% (100/130) fasted for at least 1 day, 72.3% (94/130) fasted for at least 15 days, and 48.5% (63/130) fasted for 30 days. The majority (63.0%, 63/100) reported personal decision as a reason to fast. Fear of diabetic complications (58.6%, 17/29) and previous complications related to fasting (48.3%, 14/29) were the most common reasons for not fasting. Adjustment of diabetic medication regimen occurred for 84.6% (115/136) of participants, and 72.8% (99/136) changed their treatment dose. The incidence and number of adverse events for confirmed and severe hypoglycemia were similar before and during Ramadan. Almost half of participants had access to diabetes education (45.6%, 62/136). Conclusion: The DAR-MENA study showed that despite the risks associated with fasting for people with type 1 diabetes, almost half fasted for the full 30 days of Ramadan with no significant change in hypoglycemia events. Since the current International Diabetes Federation and Diabetes and Ramadan guidelines do not endorse fasting for people with type 1 diabetes, it is important that those who insist on fasting work closely with their healthcare practitioner to avoid any complications.

KW - Epidemiology

KW - Fasting

KW - Hypoglycemia

KW - Ramadan

KW - Type 1 diabetes

UR - https://www.scopus.com/pages/publications/85081581013

U2 - 10.1007/s12325-020-01267-4

DO - 10.1007/s12325-020-01267-4

M3 - Article

C2 - 32144714

AN - SCOPUS:85081581013

SN - 0741-238X

VL - 37

SP - 1550

EP - 1563

JO - Advances in Therapy

JF - Advances in Therapy

IS - 4

ER -