Ramadan fasting in people with diabetes and chronic kidney disease (CKD) during the COVID-19 pandemic: The DaR global survey

Mohamed Hassanein; Sanobia Yousuf; Muhammad Yakoob Ahmedani; Alaa Albashier; Inass Shaltout; Alice Yong; Khadija Hafidh; Zanariah Hussein; Majd Aldeen Kallash; Naji Aljohani; Hui Chin Wong; Mehmet Akif Buyukbese; Tahseen Chowdhury; M E R Z O U K I Fadhila; Sri Wahyu Taher; Jamal Belkhadir; Rachid Malek; Noor Rafhati Adyani Abdullah; Shehla Shaikh; Majid Alabbood

doi:10.1016/j.dsx.2023.102799

Ramadan fasting in people with diabetes and chronic kidney disease (CKD) during the COVID-19 pandemic: The DaR global survey

Diabetes Metab Syndr. 2023 Jul;17(7):102799. doi: 10.1016/j.dsx.2023.102799. Epub 2023 Jun 2.

Authors

Mohamed Hassanein¹, Sanobia Yousuf², Muhammad Yakoob Ahmedani³, Alaa Albashier⁴, Inass Shaltout⁵, Alice Yong⁶, Khadija Hafidh⁷, Zanariah Hussein⁸, Majd Aldeen Kallash⁹, Naji Aljohani¹⁰, Hui Chin Wong¹¹, Mehmet Akif Buyukbese¹², Tahseen Chowdhury¹³, M E R Z O U K I Fadhila¹⁴, Sri Wahyu Taher¹⁵, Jamal Belkhadir¹⁶, Rachid Malek¹⁷, Noor Rafhati Adyani Abdullah¹⁸, Shehla Shaikh¹⁹, Majid Alabbood²⁰

Affiliations

¹ Dubai Hospital, Mohamed Bin Rashed University, United Arab Emirates. Electronic address: [email protected].
² Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan. Electronic address: [email protected].
³ Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan. Electronic address: [email protected].
⁴ Dubai Hospital, Dubai, University of Sharjah UAE, United Arab Emirates. Electronic address: [email protected].
⁵ Internal Medicine and Diabetes, Faculty of Medicine, Cairo University, Egypt. Electronic address: [email protected].
⁶ Endocrine Centre, RIPAS Hospital, Brunei Darussalam. Electronic address: [email protected].
⁷ Diabetes Unit, Department of Medicine, Rashid Hospital, Dubai Academic Health Corporation, Saudi Arabia. Electronic address: [email protected].
⁸ Department of Internal Medicine, Hospital Putrajaya, Putrajaya, Malaysia. Electronic address: [email protected].
⁹ King Fahad Medical City, OEMC Department, Alriyadh, Saudi Arabia. Electronic address: [email protected].
¹⁰ Obesity, Endocrine and Metabolic Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. Electronic address: [email protected].
¹¹ Division of Endocrinology, Department of Internal Medicine, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia. Electronic address: [email protected].
¹² Professor of Internal Medicine, Medistate Kavaick Hospital, ISTANBUL, Turkey. Electronic address: [email protected].
¹³ Department of Diabetes and Metabolism, The Royal London Hospital, Whitechapel, London, UK. Electronic address: [email protected].
¹⁴ University of Tizi Ouzou Algeria, CES Diabetology University of Sétif, Algeria. Electronic address: [email protected].
¹⁵ Simpang Kuala Health Clinic, Alor Setar Kedah, Malaysia. Electronic address: [email protected].
¹⁶ Endocrinologist - Diabetologist, Rabat, Morocco, President of Moroccan League for the Fight Against Diabetes, Chair of IDF Mena Region. Electronic address: [email protected].
¹⁷ Ferhat Abbas Setif University, Algeria. Electronic address: [email protected].
¹⁸ Endocrinology Unit, Department of Medicine, Sultanah Bahiyah Hospital, Alor Setar, Malaysia. Electronic address: [email protected].
¹⁹ Saifee Hospital, Mumbai, Treasurer Maharashtra ESI Executive Committee Member ESI, India. Electronic address: [email protected].
²⁰ Department of Medicine, Alzahra College of Medicine, University of Basrah, Iraq. Electronic address: [email protected].

Abstract

Background and aims: The DaR Global survey was conducted to observe the impact of the COVID-19 pandemic on the intentions to fast and the outcomes of fasting in people with diabetes and chronic kidney disease (CKD).

Methods: Muslim people with diabetes and CKD were surveyed in 13 countries shortly after the end of Ramadan 2020, using a simple Survey Monkey questionnaire.

Results: This survey recruited 6736 people with diabetes, of which 707 (10.49%) had CKD. There were 118 (16.69%) people with type1 diabetes (T1D), and 589 (83.31%) were with type2 diabetes (T2D). 62 (65.24%) people with T1D and 448 (76.06%) people with T2D had fasted with CKD. Episodes of hypoglycaemia and hyperglycaemia were more frequent among people with T1D compared to T2D, 64.52% and 43.54% vs 25.22% and 22.32% respectively. Visits to the emergency department and hospitalization were more frequent among people with CKD, however no significant difference was found between people with T1D and T2D.

Conclusion: The COVID-19 pandemic had only a minor effect on the intention to fast during Ramadan in people with diabetes and CKD. However, hypoglycaemia and hyperglycaemia were found to be more frequent, as well as emergency visits and hospital admissions among people with diabetic kidney disease. Prospective studies are needed in future to evaluate the risk indicators of hypoglycaemia and hyperglycaemia among fasting people with CKD, especially in the context of different stages of kidney disease.

Keywords: COVID-19; Chronic kidney disease; Diabetes; Ramadan fasting.

MeSH terms

COVID-19* / epidemiology
Diabetes Mellitus, Type 1* / complications
Diabetes Mellitus, Type 1* / epidemiology
Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / epidemiology
Fasting
Humans
Hyperglycemia* / epidemiology
Hypoglycemia* / epidemiology
Hypoglycemic Agents
Islam
Pandemics
Renal Insufficiency, Chronic* / epidemiology
Surveys and Questionnaires

Substances

Hypoglycemic Agents