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Background <p>Diabetic ketoacidosis remains a significant concern among pediatric patients with diabetes. Ramadan and associated lifestyle changes in pediatric patients (sleeplessness and metabolic stress-intermittent dehydration) should increase the risk of diabetes emergencies.</p> Objective <p>This study aimed to investigate the specific characteristics of diabetic ketoacidosis (DKA) episodes among pediatric patients with diabetes during the fasting month of Ramadan.</p> <p>Research Design and Methods: A bicentric retrospective analysis was conducted on pediatric patients with DKA admitted to the hospitals (Mouwasat hospital Dammam and khobar,ksa) during a four-year period relative to Ramadan. DKA episodes were categorized as mild, moderate, or severe DKA,and according to corrected electrolyte disturbance in many subcategories (hypernatremic, hyponatremic, or isonatremic DKA and as hypokalemic, normokalemic, or hyperkalemic DKA). A comparative analysis was then performed between two groups defined according to the time of occurrence of DKA during the lunar years: the Ramadan group and the non-Ramadan group.</p> Results <p>The median age of patients who presented with DKA during Ramadan was [8 (6–11)], with [55%] being male. Among the patients with DKA, 100% had type 1 diabetes mellitus, while [1.7%] had type 2 diabetes mellitus or neonatal diabetes during non-fasting months. The majority of DKA episodes occurred within the first decade of Ramadan [55%]. Variations in demographic factors and electrolyte disturbances among patients with DKA occurring during Ramadan vs. non-Ramadan did not reach statistical significance. The median pH at admission was lower during Ramadan than during non-fasting months (<i>p</i> = 0.02), but there were no significant differences in terms of DKA severity (36.4% vs. 14.2%, <i>p</i> = 0.08). An alarm bell concerns an increased incidence of complications during Ramadan (18.2% vs. 1.6%, <i>p</i> = 0.04).</p> Conclusions <p>Diabetic ketoacidosis remains a significant concern among pediatric patients with diabetes during Ramadan. Healthcare providers should emphasize the importance of close monitoring, early detection, and prompt intervention to prevent DKA complications during this religious observance.</p>

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Characteristics and specificity of diabetic ketoacidosis during Ramadan in pediatrics

  • 期刊论文

  • 发表日期：

    2026年7月21日

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  • Hend Elber,
  • Selmen Wannes,
  • Gehad Mohamed Gamal,
  • Asma Marzouk,
  • Sarah Ali Saleh,
  • Munther Khalil,
  • Rami Haddad,
  • Manel Ben Fredj,
  • Hisham Momattin

摘要

Background

Diabetic ketoacidosis remains a significant concern among pediatric patients with diabetes. Ramadan and associated lifestyle changes in pediatric patients (sleeplessness and metabolic stress-intermittent dehydration) should increase the risk of diabetes emergencies.

Objective

This study aimed to investigate the specific characteristics of diabetic ketoacidosis (DKA) episodes among pediatric patients with diabetes during the fasting month of Ramadan.

Research Design and Methods: A bicentric retrospective analysis was conducted on pediatric patients with DKA admitted to the hospitals (Mouwasat hospital Dammam and khobar,ksa) during a four-year period relative to Ramadan. DKA episodes were categorized as mild, moderate, or severe DKA,and according to corrected electrolyte disturbance in many subcategories (hypernatremic, hyponatremic, or isonatremic DKA and as hypokalemic, normokalemic, or hyperkalemic DKA). A comparative analysis was then performed between two groups defined according to the time of occurrence of DKA during the lunar years: the Ramadan group and the non-Ramadan group.

Results

The median age of patients who presented with DKA during Ramadan was [8 (6–11)], with [55%] being male. Among the patients with DKA, 100% had type 1 diabetes mellitus, while [1.7%] had type 2 diabetes mellitus or neonatal diabetes during non-fasting months. The majority of DKA episodes occurred within the first decade of Ramadan [55%]. Variations in demographic factors and electrolyte disturbances among patients with DKA occurring during Ramadan vs. non-Ramadan did not reach statistical significance. The median pH at admission was lower during Ramadan than during non-fasting months (p = 0.02), but there were no significant differences in terms of DKA severity (36.4% vs. 14.2%, p = 0.08). An alarm bell concerns an increased incidence of complications during Ramadan (18.2% vs. 1.6%, p = 0.04).

Conclusions

Diabetic ketoacidosis remains a significant concern among pediatric patients with diabetes during Ramadan. Healthcare providers should emphasize the importance of close monitoring, early detection, and prompt intervention to prevent DKA complications during this religious observance.