糖尿病患者在斋月期间禁食的风险分层：阿拉伯糖尿病与代谢研究协会的共识。
Risk Stratification in People with Diabetes for Fasting During Ramadan: Consensus from Arabic Association for the Study of Diabetes and Metabolism.
机构信息
Internal Medicine and Diabetes Department, Cairo University, Cairo, Egypt.
Internal Medicine and Diabetes Department, Minia University, Minia, Egypt.
出版信息
Curr Diabetes Rev. 2024;20(7):e201023222409. doi: 10.2174/0115733998249793231005105724.
BACKGROUND
Current international guidelines recommend a pre-Ramadan risk assessment for people with diabetes (PwDM) who plan on fasting during the Holy month. However, a comprehensive risk assessment-based recommendation for the management of PwDM intending to fast is still controversial. Therefore, the Arabic Association for the Study of Diabetes and Metabolism (AASD) developed this consensus to provide further insights into risk stratification in PwDM intending to fast during Ramadan.
METHODS
The present consensus was based on the three-step modified Delphi method. The modified Delphi method is based on a series of voting rounds and in-between meetings of the expert panel to reach agreements on the statements that did not reach the consensus level during voting. The panel group comprised professors and consultants in endocrinology (both adult and pediatric). Other members included experts in the fields of cardiovascular medicine, nephrology, ophthalmology, and vascular surgery, affiliated with academic institutions in Egypt.
RESULT
In PwDM who intend to fast during Ramadan, risk stratification is crucial to optimize patient outcomes and prevent serious complications. The present consensus provides risk assessment of those living with diabetes according to several factors, including the type of diabetes, presence, and severity of complications, number of fasting hours, and other socioeconomic factors. According to their risk factors, patients were classified into four categories (very high, high, moderate, and low risk).
CONCLUSION
Future research is warranted due to the controversial literature regarding the impact of fasting on certain comorbidities.
背景
目前的国际指南建议计划在圣月期间斋戒的糖尿病患者（PwDM）在斋月前进行风险评估。然而，对于打算斋戒的 PwDM 管理，基于全面风险评估的建议仍存在争议。因此，阿拉伯糖尿病与代谢研究协会（AASD）制定了本共识，以提供更多关于打算在斋月期间斋戒的 PwDM 进行风险分层的见解。
方法
本共识基于三步改良 Delphi 法制定。改良 Delphi 法基于一系列投票轮次和专家小组的中间会议，以就投票中未达成共识的声明达成一致。小组由内分泌学教授和顾问（成人和儿科）组成。其他成员包括与埃及学术机构相关的心血管医学、肾脏病学、眼科学和血管外科学领域的专家。
结果
在打算在斋月期间斋戒的 PwDM 中，风险分层对于优化患者结局和预防严重并发症至关重要。本共识根据糖尿病类型、并发症的存在和严重程度、禁食时间长短以及其他社会经济因素等因素，为糖尿病患者提供了风险评估。根据其风险因素，患者被分为四类（极高、高、中、低风险）。
结论
鉴于关于斋戒对某些合并症影响的文献存在争议，需要进行进一步的研究。
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