Overdiagnosis of gestational diabetes mellitus during Ramadan: a retrospective population-based study in Catalonia, Spain
Por:
Carrasco, M, Vlacho, B, Franch-Nadal, J, Real, J, Gabriela Monroy Rodríguez, Soldevila, B, Mauricio, D and Hernández, M
Publicada:
20 ene 2026
Resumen:
Background Fasting during Ramadan is widely practiced, with nearly a quarter of the world's population identifying as Muslim. However, it remains unclear whether Ramadan-associated practices influence gestational diabetes mellitus (GDM) diagnosis. The aim of our study was to investigate the possible association between the practice of Ramadan and the outcome of diagnostic tests for GDM. Methods We performed a retrospective study using the SIDIAP primary care database in Catalonia, Spain, covering 2010-2019. We included 35,054 pregnancy episodes screened for GDM in women aged 18-50 years without prior diabetes from Muslim-majority countries (MMC). Women from the MMC group were matched by calendar age (1:1) with women from non-Muslim-majority countries (control group). GDM incidence and plasma glucose values from diagnostic testing were compared between Ramadan and non-Ramadan periods in both groups. General linear and mixed models were applied to assess whether the Ramadan period was associated with increased GDM diagnosis and glucose values. Results In the control group, GDM incidence was similar during Ramadan and non-Ramadan periods (5.57% vs. 5.52%; p = 0.930). In contrast, the MMC group showed a significantly higher GDM rate during Ramadan (12.8% vs. 8.84%; p < 0.001). The adjusted regression model, for maternal age, BMI, number of pregnancies, blood pressure, and socioeconomic status, confirmed that the RAM period was associated with a higher risk of GDM in women from Muslim countries (MMC group) than those in the control group (OR for interaction term = 1.51; 95% CI, 1.26-1.81). Conclusions Among women from Muslim-majority countries, the rate of GDM diagnosis was higher during Ramadan. This finding may reflect a potential influence of fasting or other Ramadan-related factors on glucose testing and diagnostic practices. Clinicians should consider the possible impact of Ramadan timing when scheduling GDM screening. Further studies are warranted to confirm these observations and explore underlying mechanisms.
Filiaciones:
Carrasco, M:
Univ Hosp Arnau de Vilanova, Dept Endocrinol & Nutr, Lleida, Spain
Univ Lleida UdL, Dept Med, Lleida 25003, Spain
Vlacho, B:
Inst Salud Carlos III, CIBER Diabet & Enfermedades Metab Asociadas, Barcelona 08041, Spain
Fundacio Inst Univ Recerca Atencio Primaria Salut, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona 08041, Spain
Franch-Nadal, J:
Inst Salud Carlos III, CIBER Diabet & Enfermedades Metab Asociadas, Barcelona 08041, Spain
Fundacio Inst Univ Recerca Atencio Primaria Salut, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona, Spain
Inst Catala Salut, Primary Hlth Care Ctr, Gerencia Ambit Atencio Primaria Barcelona Ciutat, Barcelona 08007, Spain
Real, J:
Hosp La Santa Creu & St Pau, Digital Hlth Validat Ctr, St Pau Campus Salut Barcelona, Barcelona, Catalonia, Spain
Inst Recerca St Pau IR St Pau, St Quinti 77, Barcelona 08041, Spain
Gabriela Monroy Rodríguez:
Univ Hosp Arnau de Vilanova, Dept Endocrinol & Nutr, Lleida, Spain
Inst Recerca Biomed Lleida, Obes Diabet & Metab ODIM Res Grp, Lleida, Spain
St Joan Deu Res Fdn, Barcelona, Spain
Soldevila, B:
Inst Salud Carlos III, CIBER Diabet & Enfermedades Metab Asociadas, Barcelona 08041, Spain
Univ Hosp Germans Trias I Pujol, Dept Endocrinol & Nutr, Badalona, Spain
Germans Trias & Pujol Res Inst, Badalona, Spain
Autonomous Univ Barcelona, Dept Med, Bellaterra 08193, Spain
Mauricio, D:
Inst Salud Carlos III, CIBER Diabet & Enfermedades Metab Asociadas, Barcelona 08041, Spain
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona 08041, Spain
Inst Recerca St Pau IR St Pau, St Quinti 77, Barcelona 08041, Spain
Univ Vic Cent Univ Catalonia UVic UCC, Fac Med, Vic 08500, Spain
Hernández, M:
Univ Hosp Arnau de Vilanova, Dept Endocrinol & Nutr, Lleida, Spain
Univ Lleida UdL, Dept Med, Lleida 25003, Spain
Inst Recerca Biomed Lleida, Obes Diabet & Metab ODIM Res Grp, Lleida, Spain
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