Browsing by Author "Hassanein, Mohamed"

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Characteristics of non-fasting patients with diabetes type 2 in the DAR global surveys of 2020 and 2022
(2024) Hassanein, Mohamed; Hafidh, Khadija
Abstract Introduction: The decision to fast or not is quite complex. Personal, medical and religious matters may influence it for individuals with diabetes. However, a diagnosis of diabetes does not constitute an automatic exemption from Ramadan fasting. We aimed to evaluate the characteristics of the non-fasting cohort and explore the potential reasons during Ramadan through the global Ramadan surveys of 2020 and 2022. Method: The Diabetes and Ramadan (DaR) Global Study is an observational retrospective survey conducted between 2020 and 2022, which included adult patients (18 and older) who fasted and those who opted not to fast. The survey captured demographic data and patient characteristics (co-morbidities, duration and type of diabetes, diabetes-related complications and medications, development of acute complications during Ramadan, hospitalisations and ER visits) for both groups. Results: Of 12,059 patients, 1822 (14.5 %) did not fast during Ramadan; that population leaned towards females (54.6 %). They had an average age of 60.58 years (SD=12.12) with a statistically significant difference from the fasting population, averaging 54.29§11.45 (p = 0.000). Also of note was the more significant average duration of diabetes in the non-fasting cohort (12.54 years vs 9.44). There are notable regional differences in rates of fasting that ranged between 6.3 % and up to 51.2 % of patients opting not fast in certain regions (Chart 1). The risk factors that showed apparent differences of high statistical significance (p ≤ 0.001) included: long duration of diabetes of over ten years, age above 60+ years, HbA1c value over 9 %, use of insulin therapy, and being affected by one or more vascular complications (these include CKD, CVD, and diabetic foot problems). Conclusions: Many factors and comorbidities might influence patients’ decisions when planning Ramadan fasting. The non-fasting population’s demographic and clinical profiles reveal distinctive features, emphasising a need for tailored risk assessments. Furthermore, regional disparities in the decision to fast underscore the multifaceted nature of this decision-making process. The new IDF-DAR risk assessment tool can help to stratify patients’ risk during Ramadan fasting and bridge the gap among different populations and cultures.
MiniMed 780G System Use in Type 1 Diabetes During Ramadan Intermittent Fasting: A Systematic Literature Review and Expert Recommendations
(2024-08) Hassanein, Mohamed
Abstract This article offers a systematic literature review (SLR) on the use of the MiniMed 780G automated insulin delivery system (MM780G) in people with type 1 diabetes (PwT1D) during Ramadan intermittent fasting. It also presents consensus recommendations on the use of MM780G during the Ramadan period. The SLR was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. The recommendations resulted from a consensus-forming process involving a panel of experts. The process considered evidence found in the SLR as well as the expert opinions. In total, six studies were included in the SLR. The evidence and expert opinions led to recommendations related to (a) pre-Ramadan counseling of MM780G users who plan to fast; (b) suggested MM780G settings, meal announcement strategy, and safety aspects during Ramadan (including a contingency plan); and (c) post-Ramadan transition into and out of Eid-al-Fitr festivities. The SLR findings showed that the MM780G maintains glycemic control at target in PwT1D during Ramadan (meeting continuous glucose monitoring-based clinical targets proposed by the International Consensus on Time-in-Range) while ensuring low rates of hypoglycemia and diabetic ketoacidosis. Automated insulin delivery also helps PwT1D fast more days of Ramadan compared with users of other less advanced modalities of treatment. Pre-Ramadan guidance on specific aspects of the MM780G along with the International Diabetes Federation and Diabetes and Ramadan International Alliance counseling guidelines is recommended. There is still a challenge with post-Iftar hyperglycemia, which could potentially be mitigated by following the recommendations outlined in this article.
Prevalence and associated risk factors of overweight and obesity among adult population in Dubai: a populationbased cross-sectional survey in Dubai, the United Arab Emirates
(2023) Alawadi, Fatheya; Hassanein, Mohamed; Al Zarooni, Amer; Al Suwaidi, Hanan; Hassan Khamis, Amar; Alsheikh-Ali, Alawi; Alnakhi, Wafa Khamis
Objective: To study the prevalence of overweight and obesity and determine the associated risk factors among adults in Dubai. Design and setting: A cross-sectional survey with a multistage, stratified random sampling design was conducted in the Emirate of Dubai in 2019. Participants: The study included 2142 adults aged 18+ years in the Emirate of Dubai. Results: The overall prevalence of obesity, which was defined as body mass index (BMI) ≥30 kg/m2 , was 17.8%. The highest obesity rates were reported among women (21.6%) and the United Arab Emirates (UAE)- nationals (39.6%). Moreover, 39.8% of the population was overweight (BMI ≥25–29.9 kg/m2 ). Multivariate logistic regression showed associations between obesity and age, sex, nationality, hypertension and occupation. Obesity increases with age, with the highest risk at age group 50–59 years (OR 4.30; 95%CI 1.57 to 11.78) compared with the reference group (18–24 years). Females had a higher risk of obesity than males (OR 1.62; 95%CI 1.10 to 2.38). Compared with those in the reference group (Western and others), UAE nationals, other Arabs and Asians were more likely to be obese ((OR 2.08; 95%CI 1.18 to 3.67), (OR 3.61; 95%CI 2.41 to 5.44) and (OR 1.98; 95%CI 1.12 to 3.50), respectively). Clerical and service workers (OR 4.50; 95%CI 2.54 to 8.00) and elementary and unskilled occupation categories (OR 2.57; 95%CI 1.56 to 4.25) had higher risks of obesity than the reference group (professionals), p<0.01). Hypertensive individuals had a higher risk of obesity than normotensive individuals (OR=3.96; p<0.01). Conclusions: Obesity and overweight are highly prevalent among adults in Dubai and are remarkably associated with sociodemographic and behavioural risk factors. Comprehensive strategic initiatives are urgently needed to control obesity in the high-risk populations in the Emirate of Dubai.