Comparison Between High- and Low-Risk Diabetic Patients Who Fast Ramadan: A Prospective Cohort Study

Objectives: The aim of this study is to compare the low-risk patients with the high- and very high-risk patients who choose to fast during Ramadan regarding the rates of breakfasting, hypoglycemia, hyperglycemia, hospitalization, and death. Patients and Methods: This is an observational, analytic, 1-month prospective, cohort study that involved patients with diabetes mellitus who choose to fast during the month of Ramadan in the Muslim year 1437. The patients were divided into two cohorts: Cohort 1 (high-risk) consisted of 83 patients who were categorized as high/very high-risk according to the International Diabetes Federation–Diabetes and Ramadan International Alliance guidelines on diabetes and Ramadan and Cohort 2 (low-risk) consisted of 65 patients categorized as moderate/low risk. Results: The overall of whole month fasting rate was 88% (100% in the low-risk group and 79% in the high-risk group, P = 0.000), and the rate of hypoglycemia was 12% (20.9% in the high-risk group vs. 0% in the low-risk group, P = 0.002). The rate of severe hyperglycemia was 7.7% (13.5% in the high-risk group vs. 0% in the low-risk group, P = 0.14). Conclusions: Patients in the high-risk category were significantly more likely to breakfasting during Ramadan than those in the low-risk category. Hypoglycemia was significantly higher in the high-risk group. The rates of severe hyperglycemia, hospitalization, and presumed mortality were not significantly higher in the high-risk group.