R. Elmehdawi, M. Ehmida and H. Elmagrehi (2009). Incidence of Diabetic Ketoacidosis during Ramadan Fasting in Benghazi-Libya. Oman medical journal, 24(2), 99-102. https://doi.org/10.5001/omj.2009.23

PubMed 22334853

[Abstract]
OBJECTIVES: Ramadan is the ninth month on the lunar calendar and it is a holy month for Muslims during which all healthy adults must fast from dawn to sunset. The risk of diabetic ketoacidosis is thought to be higher during Ramadan fasting due to insulin and glucagon alterations.

METHODS: A descriptive retrospective analysis of the records of all patients admitted with diabetic ketoacidosis to all Benghazi hospitals during the lunar year 1428 Hijri (2007-2008).

RESULTS: Fifteen episodes occurred during Ramadan compared to a mean of 19.45 episodes/month during the other lunar months (p<0.001), and there was no significant difference in the mean age (37.6±10 vs. 38.3±19, p=0.8), mortality rate (13.3% vs.14.4%, p=0.9) or in the length of hospitalization during Ramadan. The commonest precipitating factor for diabetic ketoacidosis during Ramadan was infection (46.6%) followed by miss dosing.

CONCLUSION: There was no increase in the incidence and mortality from DKA during Ramadan which might indicate that Ramadan fasting is not a significant risk factor for diabetic ketoacidosis.