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
ISSN: 17417015





BMC Medicine
Editorial
BMC, CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 24 Número: 1
Páginas:
WOS Id: 001688456900001
ID de PubMed: 41559733
imagen Green Submitted, gold

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