The frequency of major complications among fasting people with diabetes according to risk categories of IDF-DAR guidelines 2016

Aim/background: To determine the frequency of major complications among fasting people with diabetes according to risk categories of IDF-DAR guidelines 2016. Methods: This prospective observational study was conducted around Ramadan of 2017, at Baqai Institute of Diabetology and Endocrinology, Karachi, Pakistan. People with diabetes having intention to fast during Ramadan were recruited. Demographic data collection along with risk categorization was done during pre-Ramadan visit. Structured education was given on one to one basis to each of the study participants. Assessment of complications was made during post Ramadan visit. Results: There were 131 participants in this study. Mean age was 53.77 +/- 12.67 years. Sixty three percent were males. 4.58% were of type 1 diabetes while 95.41 were of type 2 diabetes. Mean duration of diabetes was 9.92 +/- 7.752 years and mean HbA1c was 8.711 +/- 1.878. Major hypoglycemia occurred in 31.2% of very high-risk category only. None of the high risk and moderate/low risk categories had major hypoglycemia. There was no major hyperglycemia noted in any of the categories of patients. 50% of very high risk and 3.3% of high-risk category required breaking of fast. None of the participants required hospitalization. Conclusion: In this prospective study, majority of fasting people with diabetes fall into high risk category and did not develop major complications. Very high-risk category had highest number of complications while low to moderate category develop none. Further large-scale studies are needed to validate our finding.