• Eman M Alfadhli, Taif S Alharbi, Abrar M Alrotoie, Asia A Aljohani, Amal S Qari, Bashaer A Alsubhi, Aram H Alsaedi, and Alaa A Aljohani.
• From the Medical College (Alfadhli, Alharbi, Alrotoie, Asia Aljohani, Qari, Alsubhi, Alsaedi), Taibah University, from the Department of Internal Medicine (Alfadhli), King Faisal Specialist Hospital and Research Center, and from the Diabetes Center (Alaa Aljohani), King Salman Bin Abdulaziz Medical City, Al-Madinah Al-Munawarah, Kingdom of Saudi Arabia.
• Saudi Med J. 2024 Jan 1; 45 (1): 869286-92.

ObjectivesTo assess the validity of the new International Diabetes Federation-Diabetes and Ramadan International Alliance (IDF-DAR) risk stratification tool for Ramadan fasting in predicting diabetic patients' ability to fast safely.MethodsA prospective observational study was carried out during Ramadan 2022 at the Diabetes Center, King Fahad Hospital, Al-Madinah Al-Munawarah, Saudi Arabia. The IDF-DAR risk stratification tool was used to calculate fasting risk for diabetic patients pre-Ramadan. The patients were allocated into 3 categories: high, moderate, and low risk. Fasting was left up to the patients and their healthcare providers. Participants filled out a log-sheet each day of Ramadan showing whether they completed the fast. A final interview was carried out after Ramadan to assess patients' fasting experiences.ResultsWe included 466 patients with diabetes: 79.4% with T2DM and 20.6% with T1DM. Based on the IDF-DAR score, 265 (56.9%) patients were classified as high risk, 115 (24.7%) as moderate risk, and 86 (18.4%) as low risk. Non-fasting the whole month of Ramadan was statistically relevant to the IDF-DAR risk stratification score. High-risk individuals were more likely to experience hypoglycemia and hyperglycemia than those with a moderate or low risk. But overall, 70.4% of people at moderate risk and 53.2% of the ones at high risk observed Ramadan's complete fast.ConclusionThe IDF-DAR has proven to be reliable and valid for predicting the risk of adverse events associated with fasting in diabetic patients. Nonetheless, it might overestimate the risk of fasting for some patients.Copyright: © Saudi Medical Journal.

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