title: Multi-country retrospective observational study of the management and outcomes of patients with Type 2 diabetes during Ramadan in 2010 (CREED).
abstract: OBJECTIVE
  To describe the characteristics and management of patients with diabetes who chose to fast during Ramadan in 2010.
  
  
  METHODS
  This was a multi-country, retrospective, observational study, supplemented with physician and patient questionnaires, with data captured before, during and after Ramadan. A total of 508 physicians in 13 countries enrolled 3777 patients and a total of 3394 evaluable cases were analysed. We report on the subset of patients with Type 2 diabetes, which included 3250 patients (95.8%).
  
  
  RESULTS
  Oral anti-hyperglycaemic therapy was the predominant pre-Ramadan therapy for most patients (76.6%). The treatment regimen was modified before Ramadan for 39.3% of all patients (34.9% for patients on oral drugs alone, 47.1% for patients on injectable drugs alone). Almost all physicians (96.2%) reported providing fasting-specific advice to patients and 62.6% report using guidelines or recommendations for the management of diabetes during Ramadan. In all, 64% of patients reported fasting everyday of Ramadan and 94.2% fasted for at least 15 days.
  
  
  CONCLUSIONS
  Physicians have increasingly adopted multiple approaches to the management of fasting during Ramadan, including the adoption of international and/or national guidelines, providing fasting-specific advice and adjusting treatment regimens, such that patients are able to fast for a greater number of days without acute complications. Additional research is needed to explore physician and patient beliefs and practices to inform the evidence-based management of diabetes while fasting, both during and outside of Ramadan, and to identify and address barriers to the universal uptake of techniques to facilitate that management.
authors.affiliation: Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Babineaux
authors.affiliation: Eli Lilly, Cairo, Egypt.
authors.forename: D
authors.initials: D
authors.lastname: Toaima
authors.affiliation: Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: K S
authors.initials: KS
authors.lastname: Boye
authors.affiliation: Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: A
authors.initials: A
authors.lastname: Zagar
authors.affiliation: Lilly UK, Basingstoke, UK.
authors.forename: A
authors.initials: A
authors.lastname: Tahbaz
authors.affiliation: Eli Lilly SA, Dubai, United Arab Emirates.
authors.forename: A
authors.initials: A
authors.lastname: Jabbar
authors.affiliation: Dubai Hospital, Dubai, United Arab Emirates.
authors.forename: M
authors.initials: M
authors.lastname: Hassanein
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007514:Islam; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin