cliot (version 1.0.0)

idf_dar_fasting_risk: IDF-DAR Fasting Risk Assessment for Ramadan

Description

Calculates the risk score for patients with diabetes who intend to fast during Ramadan, based on the International Diabetes Federation (IDF) and Diabetes and Ramadan (DAR) International Alliance guidelines (2021). The score stratifies patients into Low, Moderate, and High risk categories.

Usage

idf_dar_fasting_risk(type_1_diabetes, duration_gt_10_years, hba1c_value,
                     hypoglycemia_points, complication_points, medication_points,
                     smbg_not_performed, pregnancy, frailty_cognitive,
                     intense_labor, previous_ramadan_bad)

Value

A list containing:

Total_Risk_Score

The calculated risk score.

Risk_Category

Classification (Low <=3, Moderate 3.5-6, High >6).

Recommendation

Guidance on fasting safety.

Arguments

type_1_diabetes

Numeric (0 or 1). Is the patient Type 1? (1 = Yes, +1 point).

duration_gt_10_years

Numeric (0 or 1). Is the duration of diabetes > 10 years? (1 = Yes, +1 point).

hba1c_value

Numeric. Current HbA1c percentage. (7.5-9.0: +1 pt; >9.0: +2 pts).

hypoglycemia_points

Numeric. Points based on hypoglycemia history: 0: None/Stable. 1: Hypo occurring but stable/aware. 5.5: Recent severe hypoglycemia, hypoglycemia unawareness, or DKA/HHS within 3 months.

complication_points

Numeric. Sum of points for complications: 0: None. 2: Stable cardiovascular disease. 4: Unstable CVD, Heart Failure, Stroke. 4: Renal impairment eGFR 30-60. 5.5: eGFR < 30 or Dialysis.

medication_points

Numeric. Sum of points for medications used: 0: Metformin, TZD, GLP-1, DPP-4. 0.5: Sulfonylurea (2nd gen), SGLT2 inhibitors (monitor DKA). 1: Glibenclamide (long-acting SU). 1.5: Basal insulin. 2.0: Premix insulin (once daily). 3.0: Multiple dose insulin (MDI) or Pump.

smbg_not_performed

Numeric (0 or 1). Self-monitoring of blood glucose (SMBG) is NOT performed? (1 = Yes, +2 points).

pregnancy

Numeric (0 or 1). Is the patient pregnant? (1 = Yes, +6.5 points).

frailty_cognitive

Numeric (0 or 1). Frailty, cognitive impairment, or living alone without support? (1 = Yes, +5.5 points).

intense_labor

Numeric (0 or 1). Does the patient perform intense physical labor? (1 = Yes, +1 point).

previous_ramadan_bad

Numeric (0 or 1). Previous negative experience (e.g., admission, severe hypo) during Ramadan? (1 = Yes, +1 point).

References

International Diabetes Federation and the DAR International Alliance. Diabetes and Ramadan: Practical Guidelines, 2021.

Examples

# Example 1: Low Risk T2DM
# T2 (0), <10y (0), A1c 7.0 (0), No Hypo (0), No Comps (0), Metformin (0)
idf_dar_fasting_risk(0, 0, 7.0, 0, 0, 0, 0, 0, 0, 0, 0)

# Example 2: High Risk T1DM
# T1 (1), >10y (1), A1c 9.5 (2), MDI (3), Recent Hypo (5.5)
# Score = 12.5
idf_dar_fasting_risk(1, 1, 9.5, 5.5, 0, 3, 0, 0, 0, 0, 0)