Cross-sectional studyindependent cross-checkabstract checked★ key study I-FAST-109 standard review

Type 1 diabetes and Ramadan complications

Assessment of the IDF-DAR Fasting Risk Assessment Tool to Predict Type 1 Diabetes-Related Complications During Ramadan in a Real-World Setting.

Overview

Alguwaihes AM et al.. Clin Med Insights Endocrinol Diabetes 2025 · PMID 41001082 · DOI 10.1177/11795514251376888

Among 963 Saudi adults with type 1 diabetes, those rated high risk had more complications and emergency visits when fasting.

Does the study support the specific claim? No · Methodological quality: low

Study explained simply

What did the researchers want to find out?: Test a fasting risk tool.
How was the study done?: Online survey after Ramadan 2022.
How many people, animals or samples were studied?: 963 adults with T1D.
What was actually found?: High-risk group: more ER visits; education linked to fewer visits.
How large was the observed effect?: OR 0.53 (0.34-0.82) for education.
What do the results mean in everyday life?: Fasting with type 1 diabetes can lead to emergencies; preparation with doctors helps.
What are the study's limitations?: Self-reported; no lab confirmation.
What does it say about Elawady's specific claim?: Contradicts the idea that high sugar during fasting is harmless.
Do the results apply to Germany and Europe?: Directly relevant to Arab populations including Egypt.
What can explicitly not be concluded from this study?: Exact DKA rates.

Authors: Alguwaihes AM et al.
Journal: Clin Med Insights Endocrinol Diabetes
Year: 2025
Identifier: PMID 41001082 DOI 10.1177/11795514251376888
Verification: verified – PubMed efetch 2026-10-26; Crossref update-to/updated-by check
Retracted: no
Corrections: none
Extent checked: abstract only
Conflicts of interest and funding: First author reports advisory/speaker relationships with several manufacturers (in record).

Does the IDF-DAR 2021 risk calculator predict complications in adults with type 1 diabetes fasting Ramadan?

Study design: Cross-sectional study – Cross-sectional online survey
Population: Adults with type 1 diabetes in Saudi Arabia who observed Ramadan 2022
Country: Saudi Arabia
Period: May-August 2022
Sample size: 963 (257 men, 706 women; mean age 26.5)
Inclusion and exclusion criteria: not stated in abstract

Results: 66% high risk, 34% moderate risk, none low risk. High-risk group: more days with broken fast, more complications, more diabetes-related ER visits (P<.01). Pre-Ramadan education associated with lower odds of ER visit (OR 0.53, 95% CI 0.34-0.82).
Absolute risks: not reported
Authors' conclusion: The IDF-DAR risk calculator predicts acute complications and ER visits; pre-Ramadan education may reduce complications.

OR 0.53 is an odds ratio from cross-sectional data, not a causal risk reduction (stats/I-FAST-109_idf_dar_tool.py).

Shows fasting with type 1 diabetes leads to emergency visits in a regional population, especially in high-risk individuals.

Universal biology; applies in Europe and Egypt.

Regional evidence that fasting with T1D carries real acute risk requiring assessment and education.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	low
Risk of bias	high
Precision of results	moderate
Directness	direct
Reproducibility	partly replicated
Consistency with the overall evidence	consistent
Regional transferability	high
Adequacy of the interpretation (by the archive)	not applicable