{
  "abstract": "Background Despite the high prevalence of diabetes in Qatar, Ramadan-related glycemic events remain inadequately characterized. This study examined sociodemographic, clinical and behavioral factors independently associated with hypoglycemic or hyperglycemic events among patients with diabetes during Ramadan in Qatar.Methods A retrospective analysis was conducted using routinely collected data from the Qatar Diabetes Association (QDA) Ramadan support program covering three Ramadan seasons (2022–2024). Patients with type 1 or type 2 diabetes who attended QDA diabetes education or dietetic clinics were included, regardless of fasting intention. Those with pre-diabetes or gestational diabetes were excluded. Assessments began 6–8 weeks before Ramadan, with structured follow-up throughout the month. Primary outcomes—based on patient-recorded blood glucose readings—were defined to capture the overall risk of glycemic instability during Ramadan and included (1) any hypoglycemic (<70 mg/dL) or hyperglycemic (>250 mg/dL) event and (2) any such events during fasting hours. Generalized estimating equation logistic regression models identified factors associated with hypoglycemic or hyperglycemic outcomes. Missing data were <5% and handled by complete-case analysis. Statistical significance was defined as 95% CIs excluding 1.Results The study included 374 patients; 95.5% of observations were from patients with type 2 diabetes and 43.3% reflected longer diabetes duration. Adjusted ORs indicated higher odds of hypoglycemia or hyperglycemia at any time among patients with a longer diabetes duration, a high International Diabetes Federation–Diabetes and Ramadan risk score, those who discussed a fasting plan with a physician, those who used medications known to increase hypoglycemia risk, and those who used continuous glucose-monitoring devices. During fasting hours, higher odds were observed among patients with type 1 diabetes and those with a higher daily number of recorded blood glucose readings.Conclusions The findings underscore the importance of structured pre-Ramadan risk assessment, patient-centered education, close and rigorous follow-up and individualized treatment adjustment—particularly for high-risk groups—to optimize safety and enhance the overall Ramadan experience among persons with diabetes.",
  "authors": [
    {
      "affiliations": [
        "Infectious Disease Epidemiology Group, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar"
      ],
      "name": "Zahir M Tag"
    },
    {
      "affiliations": [
        "Infectious Disease Epidemiology Group, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar",
        "Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA",
        "Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar",
        "College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar"
      ],
      "name": "Laith J Abu-Raddad"
    },
    {
      "affiliations": [
        "Qatar Diabetes Association, Doha, Qatar"
      ],
      "name": "Amel A Mustafa"
    },
    {
      "affiliations": [
        "Infectious Disease Epidemiology Group, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar",
        "Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA"
      ],
      "name": "Hiam Chemaitelly"
    },
    {
      "affiliations": [
        "Qatar Diabetes Association, Doha, Qatar"
      ],
      "name": "Abdulla O Alhamaq"
    },
    {
      "affiliations": [
        "Qatar Diabetes Association, Doha, Qatar"
      ],
      "name": "Katie G El-Nahas"
    }
  ],
  "title": "Factors associated with hypoglycemic or hyperglycemic events during Ramadan among persons with diabetes in Qatar",
  "uid": "b27002fe-71af-5c37-bac3-86ae0363e47b"
}