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CC BY 4.0 · Journal of Diabetes and Endocrine Practice
DOI: 10.1055/s-0045-1811949
Original Article

Impact of Ramadan Fasting in People with Type 1 Diabetes and Diabetic Kidney Disease: Insights from the DaR Global Survey

Authors

  • Bachar Afandi

    1   Endocrine Division, Tawam Hospital, Al Ain, United Arab Emirates
    2   Department of Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates

  • Samih Abed Odhaib

    3   Thi Qar Specialized Diabetes Endocrine and Metabolism Center, College of Medicine, Sumer University, Thi Qar, Iraq

  • Mohamed Habib

    4   Diabetes and Ramadan International Alliance, Alexandria, Egypt

  • Naji Aljohani

    5   King Fahad Medical City, Riyadh, Saudi Arabia

  • Muhammad Yaqoob Ahmedani

    6   Baqai Institute of Diabetology and Endocrinology, Karachi, Pakistan

  • Nancy Elbarbary

    7   Department of Pediatrics, Faculty of Medicine, Ain Shams University, Ain Shams, Egypt

  • Eman Alfadhli

    8   Taibah University, Madinah, Saudi Arabia

  • Majd Aldeen Kallash

    9   Diabetic Center and Endocrinology, King Fahad Medical City, Riyadh, Saudi Arabia

  • Mohamed Hassanein 

    10   Department of Diabetes and Endocrinology, Dubai Hospital, Dubai, United Arab Emirates
    11   Department of Medicine, Mohammed Bin Rashid University, Dubai, United Arab Emirates

Funding and Sponsorship None.
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Abstract

Background

Despite the scarcity of data, individuals with type 1 diabetes mellitus (T1D) and diabetic kidney disease (DKD) are considered at moderate to high risk for Ramadan fasting and are individually advised against fasting.

Objectives

This subgroup analysis of the Diabetes and Ramadan (DaR) global survey was conducted to evaluate the outcomes and characteristics of patients with T1D complicated by DKD who observe fasting and to compare their outcomes with those of fasting people living with T1D uncomplicated by DKD.

Methods

Using a specifically designed SurveyMonkey questionnaire, Muslim individuals with T1D and DKD were surveyed in several countries from different geographical regions and compared statistically to people with T1D without DKD or associated comorbidities.

Results

Note that 53.8% (N = 86) of individuals with T1D and DKD fasted during Ramadan in comparison with 74% (N = 1,523) of the control group. Those with DKD experienced higher rates of hypoglycemia (65.1%) and hyperglycemia (69.6%) than the control group (56.5 and 42.5%, respectively). They also had more frequent emergency visits and hospitalizations. Additionally, among individuals with T1D and DKD, nonfasters exhibited significant differences in biochemical markers and demographics compared with those who fasted.

Conclusion

Individuals with T1D and DKD are generally older, have multiple diabetes-related complications, and are less likely to fast during Ramadan. For those who do fast, the risks are significant, including higher rates of hypoglycemia and hospital admissions compared with the control group. Ensuring safe fasting in this population requires interdisciplinary collaboration, patient education, and expert medical guidance.

Keywords

Ramadan fasting - type 1 diabetes mellitus - diabetic kidney disease - hypoglycemia - hyperglycemia - diabetes education - self-monitoring of blood glucose - risk stratification

Authors' Contributions

All authors contributed toward conception, data collection, writing, and final approval of the manuscript.


Compliance with Ethical Principles

Ethical approval was not required for this subanalysis. Original studies were approved by the ethical committees of the participating sites.




Publikationsverlauf

Artikel online veröffentlicht:
26. September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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