{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T17:05:45Z","timestamp":1781197545068,"version":"3.54.1"},"reference-count":47,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"unspecified","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019460","name":"Weill Cornell Medicine - Qatar","doi-asserted-by":"publisher","award":["Biostatistics, Epidemiology, and Biomathematics Re"],"award-info":[{"award-number":["Biostatistics, Epidemiology, and Biomathematics Re"]}],"id":[{"id":"10.13039\/100019460","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008982","name":"Qatar National Research Fund","doi-asserted-by":"publisher","award":["NPRP grant number 10-1208-160017"],"award-info":[{"award-number":["NPRP grant number 10-1208-160017"]}],"id":[{"id":"10.13039\/100008982","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2026,5,30]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted using routinely collected data from the Qatar Diabetes Association (QDA) Ramadan support program covering three Ramadan seasons (2022\u20132024). 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\u20138 weeks before Ramadan, with structured follow-up throughout the month. Primary outcomes\u2014based on patient-recorded blood glucose readings\u2014were defined to capture the overall risk of glycemic instability during Ramadan and included (1) any hypoglycemic (&lt;70\u2009mg\/dL) or hyperglycemic (&gt;250\u2009mg\/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 &lt;5%\u2009and handled by complete-case analysis. Statistical significance was defined as 95% CIs excluding 1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2013Diabetes 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings underscore the importance of structured pre-Ramadan risk assessment, patient-centered education, close and rigorous follow-up and individualized treatment adjustment\u2014particularly for high-risk groups\u2014to optimize safety and enhance the overall Ramadan experience among persons with diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjdrc-2026-006076","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:30:22Z","timestamp":1781195422000},"page":"e006076","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with hypoglycemic or hyperglycemic events during Ramadan among persons with diabetes in Qatar"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2775-6658","authenticated-orcid":false,"given":"Zahir M","family":"Tag","sequence":"first","affiliation":[{"name":"Infectious Disease Epidemiology Group, Weill Cornell Medicine\u2013Qatar, Cornell University, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0790-0506","authenticated-orcid":false,"given":"Laith J","family":"Abu-Raddad","sequence":"additional","affiliation":[{"name":"Infectious Disease Epidemiology Group, Weill Cornell Medicine\u2013Qatar, Cornell University, Doha, Qatar"},{"name":"Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA"},{"name":"Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar"},{"name":"College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3156-7109","authenticated-orcid":false,"given":"Amel A","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Qatar Diabetes Association, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8756-6968","authenticated-orcid":false,"given":"Hiam","family":"Chemaitelly","sequence":"additional","affiliation":[{"name":"Infectious Disease Epidemiology Group, Weill Cornell Medicine\u2013Qatar, Cornell University, Doha, Qatar"},{"name":"Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1341-9014","authenticated-orcid":false,"given":"Abdulla O","family":"Alhamaq","sequence":"additional","affiliation":[{"name":"Qatar Diabetes Association, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0242-2277","authenticated-orcid":false,"given":"Katie G","family":"El-Nahas","sequence":"additional","affiliation":[{"name":"Qatar Diabetes Association, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"2026061109301722000_14.3.e006076.1","unstructured":"International Diabetes Federation . 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