The incidence of diabetic ketoacidosis during Ramadan fasting: A 10-year single-centre retrospective study

Context: There has been an increased interest in the potential metabolic derangements and acute complications of diabetes related to the Muslims' fasting during the month of Ramadan. Objectives: We compared the incidence of admissions due to diabetic ketoacidosis (DKA) during Ramadan with the admissions during other months. Methods: This is a retrospective electronic database and chart review study that included all Muslims who were admitted with DKA to Sheikh Khalifa Medical City in Abu Dhabi, United Arab Emirates. We explored the relationship of admissions to Ramadan over ten years (2005-2014). Results: There were 432 episodes of DKA involving 283 patients. Of these, 370 episodes (85.6%) involved 231 patients (81.6%) with type 1 diabetes. The number of admission episodes was not different during Ramadan from the average calendar month [3.6 +/- 2.6 (Range 0-15) episodes/month versus 3.3 +/- 2.1 (Range 1-7) episodes/month respectively, P = 0.77]. No recurrences of admissions were observed during Ramadan. There was a nonsignificant numerical tendency for more episodes in March and September (4.6 episodes for both) and fewer episodes in July (2.6 episodes) than other months; P values were 0.06; 0.13, and 0.32 respectively. This seasonality was not related to the month of Ramadan. Conclusions: The present study confirmed that DKA admissions during Ramadan were not significantly higher than the average monthly admissions over ten years. Seasonality trends were not related to Ramadan. (C) 2019 Elsevier B.V. All rights reserved.