Issue Highlights: Ramadan Fasting, Diabetes, Hypoglycemia, and Acromegaly

Welcome to the third issue of Journal of Diabetes and Endocrine Practice for 2025. This issue includes two review articles, three original research articles, and two case reports.

The first review is one of the Ramadan-Year in Review series, a thematic overview on diabetes and Ramadan fasting in 2024. The most topical aspect of diabetes care during Ramadan in 2024 was the publication of several studies on the validation and utility of International Diabetes Federation-Diabetes and Ramadan Alliance (IDF-DAR), the latest of these studies is published in this issue. The second review by Abdelgadir et al revisited the evolution in managing postbariatric hypoglycemia (PBH) with a comprehensive review and comparison between international guidelines from 2017 to 2024. PBH is increasingly recognized with the rise of individuals having various forms of bariatric surgery. The authors tracked progression in medical thoughts and practices over the past decade, covering epidemiology, pathophysiology, diagnostic challenges, and the triangle of management approaches (dietary, pharmacological, and surgical).

The three original research articles covered different subjects of special importance to clinical practice. The first was an observational study by Afandi et al of the impact of twice-weekly Islamic fasting (TWIF) practices on the cardiovascular risk factors in women with type 2 diabetes (T2D). Although the research interest has focused so far on fasting during Ramadan, TWIF is commonly observed on Mondays and Thursdays by middle-aged and older Muslim women. This pilot study found that over one-third of the studied sample of Emirati women with T2D practice TWIF. Although statistical significance was not reached, a trend suggested potential glycemic control and weight benefits. More in-depth studies on TWIF that consider various health aspects are welcome. A quick scoping review to establish the state of play is warranted to help future research directions. The second original article examined the validity and utility of the IDF-DAR risk stratification and its impact on pre-Ramadan education on diabetes-related complications in Oman by Al-Reesi et al. The authors found the IDF-DAR risk stratification is a reliable and valid tool for predicting the risk of adverse fasting events in patients with diabetes. They also underscored the vital role of pre-Ramadan education in mitigating fasting-related complications. The last original research evaluated the effect of vitamin D status on glycemic control in Saudi children and adolescents with type 1 diabetes (T1D) by Adam et al. They concluded that vitamin D levels did not correlate significantly with hemoglobin A1c levels; however, a significant inverse correlation of vitamin D levels with insulin requirements. In addition to a high prevalence of vitamin D levels inadequacy in children and adolescents with T1D. Thus, the study highlights the importance of maintaining adequate vitamin D levels in this population.

The two case reports illustrated different events in patients with acromegaly. The first reported itraconazole treatment unmasking of secondary adrenal insufficiency in a burnt-out acromegaly by Alma et al, and the second combined diabetic ketoacidosis and hyperosmolar hyperglycemic state as the first presentation of acromegaly by Alshamsi et al. Both case reports should help understand acromegaly.

Concerning the journal's life, we are doing reasonably well with a steady flow of substantial reviews and original article submissions. This occurs despite the long overdue delay in getting recognized in any of the conventional indexes for a journal in its eighth year of age. Our publisher is currently making the necessary readiness assessments for the application to be included in some databases. Content seems appropriately relevant to our readers in the targeted primary constituency of the Middle East and North Africa, as well as to the rest of the world. Although the place of single case reports in the medical literature is debatable, to help develop publishing skills in our constituency, we reserve a space for one or a couple of selected case reports of unique features, educational importance, and regional/ethnic relevance.

We hope you enjoy and benefit from the contents of this issue. We welcome your feedback and look forward to your continued support.

 

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Conflict of Interest

None declared.

Compliance with Ethical Principles

None.

Author's Contribution

Single author.

Publication History

Article published online:
01 August 2025