Ramadan is the holy month of fasting in which Muslims refrain from food, fluids, oral medications and smoking from sunrise until sunset. The Koran specifically exempts from fasting those for whom it may have harmful consequences, such as pregnant women, the elderly and those with medical conditions. Fasting is not recommended for type 1 diabetes patients, those who are non-adherent to therapy or who have poor glycemic control . These individuals in particular are at increased risk of hypo- and hyperglycemic episodes as well as metabolic complications associated with dehydration . However, many diabetes patients choose to participate despite the medical and religious advice excusing them from the Ramadan fast [3, 4, 5].
Fortunately, diabetes management strategies during Ramadan have been proposed by international medical and religious bodies [1, 6, 7, 8, 9]. General considerations include pre-Ramadan medical assessment and patient education regarding meal planning; physical activity; the need for increased frequency of blood glucose monitoring and the recognition and management of acute complications. Recommendations for diabetes medication dosing adjustments tailored for both type 1 and type 2 diabetes patients are also outlined. Despite availability of such resources, studies have identified gaps in prescribed diabetes patient care, notably inappropriate health professional discouragement towards fasting and lack of counseling regarding medications or instructions for breaking the fast [10, 11, 12].
Pharmacists as the front desk healthcare provider has a tremendous role in managing diabetic patients during ramadan.
|At least 1 – 2 months before Ramadan||
|During fasting, especially daytime||
|During Iftar (sunset meal) or Suhur (predawn meal)||
Avoid eating too much carbohydrates and fat, especially during Iftar.
What symptoms to look out for?
- Chest pain
- Fruity odour on breath
- Heart palpitation
- Muscle cramps
- Nausea & vomiting
|When you feel unwell/ experience the symptoms above||
Avoid fasting on sick days.
- American Diabetes Association Workgroup Report: Recommendations for diabetes management during Ramadan. Update 2010. Diab Care. 2010, 33: 1895-1902. 10.2337/dc10-0896.View ArticleGoogle Scholar
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- Salti I, Benard D, Detournay B, Bianchi-Biscay M, le Brigand C, Voinet C, Jabbar A, EPIDIAR study group: A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries. Results of the epidemiology of diabetes and Ramadan 1422/2001 (EPIDIAR) study. Diabetes Care. 2004, 27: 2306-2311. 10.2337/diacare.27.10.2306.View ArticlePubMedGoogle Scholar
- Robinson T, Raisler J: “Each one is a doctor for herself”: Ramadan fasting among pregnant Muslim women in the United States. Ethn Dis. 2005, 15 (1 Suppl 1): S99-S103.Google Scholar
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- Peeters B, Mehuys E, van Tongelen I, van Bever E, Bultereys L, Avonts D, Yildiz G, Remon JP, Boussery K: Ramadan fasting and diabetes: an observational study among Turkish migrants in Belgium. Prim Care Diab. 2012, 6: 293-296. 10.1016/j.pcd.2012.02.003.View ArticleGoogle Scholar