The impact of Ramadan on visits related to diabetes emergencies at a tertiary care center

Abstract

Background: Ramadan is the ninth month of the Islamic calendar were Muslims fast from dawn until sunset. This prolonged fasting period might have an impact on patients with diabetes and their disease control. This study aimed to determine the variation in visits at the Emergency Room department (ER) during Ramadan in comparison with other lunar months at a tertiary care hospital in Jeddah city in relation to the diabetes emergencies. Methodology: A retrospective cross-sectional study was conducted using electronic medical record review of patients with diabetes emergencies who visited ER of a Military hospital, from 9th to 11th lunar months during 2017–2018. Diabetes patients who visited ER and aged more than 18 years old were included. Frequency of ER visits, sociodemographic characteristics and clinical features were determined. Chi-square test, Student ‘s t-test and one-way ANOVA at p < 0.05 were used in assessing associations between variables. Results: Within the selected study period, a total of 24,498 admissions were recorded in ER. The prevalence of diabetes emergencies visits was only 0.84%. Based on inclusion criteria, a total of 133 subjects were included in the study (54.1% men, 45.9% women). Majority of whom (73.7%) were on insulin therapy, and more than half of whom (51.9%) were type 2 diabetes. There was a significant difference (p = 0.001) in the prevalence of diabetes emergencies visits between the three lunar months Shaban, Ramadan and Shawal, 7, 5 and 4%, respectively. However, the highest prevalence was not in Ramadan. Despite some correlations were identified, the study found no significant differences between frequency of ER visits and various demographic, clinical factors and diabetes profile between Ramadan and other both preceding and succeeding lunar month. Conclusion: In contrary with previous studies, a downward trend of prevalence, from Shaban to Ramadan, to Shawal was found. This indicated that fasting during month of Ramadan does not impact negatively on the diabetes emergencies in comparison with other months. Hyperglycemia among type 2 diabetes and insulin treated patients were recorded the highest feature of diabetes emergences visits during the three months studied with no significant differences between the months. These findings highlight the need of type 2 and insulin treated patients to be thoroughly assess by the Primary Care physicians and in-depth health education and guidance should be given to them.