Risk Stratification for Fasting in Diabetic Patients Based on the IDF-DAR Guideline

Fasting during Ramadan is a religious obligation and may pose a risk to diabetic patients. This study aimed to stratify diabetic patients based on the International Diabetes Federation- Diabetes and Ramadan International Alliance (IDF- DAR) guideline for the risk of fasting before Ramadan. 

A total of 317 diabetic patients attending the endocrinology clinic at Ghaem Hospital, Mashhad, Iran, participated in this cross-sectional study. The American Diabetic Association (ADA) criteria were applied to diagnose diabetes. Various parameters, including diabetes type and duration, complications, and risk factors were recorded to determine IDF-DAR-based risk. Then patients were stratified into high (IDF-DAR>6), medium (IDF-DAR: 3.5-6) and low (IDF-DAR: 0-3) risk groups accordingly. 

 Out of the 317 patients included in the study, 115 (36.3%) patients were categorized as low risk, 127 (40%) as moderate-risk, and 75 (23.7%) as high-risk groups. 

  According to the IDF-DAR guideline, majority of the patients fell into the low and moderate risk categories, suggesting that they should not be entirely exempted from fasting during the holy month of Ramadan. However, the validity of this patient stratification in various fasting populations needs to be evaluated through prospective longitudinal studies.