IDF-DAR Ramadan Fasting Risk Score calculator

Clinical inputs

• Diabetes type
• Duration of diabetes
• Hypoglycaemia
• Glycated hemoglobin
• Glucose-lowering treatment
• Self-monitoring of blood glucose
• Ketoacidosis or hyperosmolar state
• Macrovascular disease
• Estimated glomerular filtration rate
• Pregnancy
• Frailty, cognition, or age without support
• Physical labour
• Previous Ramadan experience
• Planned fasting hours

Primary source

Hassanein M et al. Diabetes and Ramadan: Practical guidelines 2021. Diabetes Res Clin Pract. DOI: 10.1016/j.diabres.2021.109185. PMID: 35016991. Table 3 and Figures 3 and 4. Each element contributes one row: type 1 diabetes 1, type 2 diabetes 0; duration ≥10 years 1, <10 years 0; hypoglycaemia unawareness 6.5, recent severe hypoglycaemia 5.5, multiple weekly hypoglycaemia 3.5, hypoglycaemia less than once a week 1, none 0; HbA1c >9% (75 mmol/mol) 2, 7.5–9% (58.5–75 mmol/mol) 1, <7.5% (58.5 mmol/mol) 0; multiple daily mixed insulin 3, basal-bolus or pump 2.5, once-daily mixed insulin 2, basal insulin 1.5, glibenclamide 1, gliclazide or gliclazide modified-release, glimepiride, or repaglinide 0.5, other therapy without a sulfonylurea or insulin 0; SMBG indicated but not done 2, done suboptimally 1, done as indicated 0; DKA or HHS in 3 months 3, in 6 months 2, in 12 months 1, none 0; unstable macrovascular disease 6.5, stable 2, none 0; eGFR <30 6.5, 30–45 4, 45–60 2, >60 0; pregnant and not within targets 6.5, pregnant within targets 3.5, not pregnant 0; impaired cognition or frail 6.5, older than 70 without home support 3.5, neither 0; highly intense physical labour 4, moderate 2, none 0; overall negative prior Ramadan experience 1, otherwise 0; fasting ≥16 hours 1, <16 hours 0. Figure 3: 0 to 3 low, 3.5 to 6 moderate, above 6 high. (2021)