Ramadan Fasting and Diabetes (2022): The Year in Review

Abstract

Abstract Objectives  The literature on the impact of Ramadan fasting (RF) on metabolic control and health in people with diabetes is widely spread in many journals making it not readily accessible to those interested in the subject. We aimed to provide a narrative overview of the global literature production in 1 year (2022) on diabetes and RF. Materials and Methods  It is a narrative, non-systematic review of the international literature from a single major medical online database (i.e., PubMed) in one calendar year (2022). Relevant literature was narrated in a concise thematic account. Results  Themes emerged from the review of the literature on RF published in 2022, including a couple of studies on the epidemiology of fasting in the real world by adults and children. Three studies involved some pathophysiological observations of metabolic and other biochemical markers. Several studies assessed the use and safety of different pharmacological therapeutic agents. Certain sulfonylureas, such as modified-release gliclazide, were considered safer than other sulfonylureas. Newer basal insulin analogs were studied in different geographical and socioeconomic settings (Gulf vs. South East Asia). The role of diabetes technology in Ramadan was the focus of several studies of insulin pumps and monitoring. Special themes were high-risk groups, pregnancy, acute complications, postbariatric surgery, and COVID-19 in Ramadan. Few studies examined the safety of sodium-glucose co-transporter-2 inhibitors as a class and individually during RF. Professional and patient perspectives released in 2022 included updated guidelines for adults and adolescents. Conclusion  In 2022's medical literature, RF and diabetes continue to address epidemiology, the burden of diabetes care on fasting patients, and discussions of concerns of patients and healthcare professionals. Risk stratification and issues of high-risk patients are still in focus for children, adolescents, and adults. Approaches to effective management still gather evidence for newer pharmacological agents and diabetes technology.