Download PDF
CC BY-NC-ND 4.0 · Avicenna J Med 2014; 04(02): 29-33
DOI: 10.4103/2231-0770.130341
REVIEW ARTICLE

The diabetic patient in Ramadan

Hassan Chamsi-Pasha
Department of Cardiology, Diabetes Centre, King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia
,
Khalid S Aljabri
Department of Endocrinology, Diabetes Centre, King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia
› Author Affiliations
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

During the month of Ramadan, all healthy, adult Muslims are required to fast from dawn to sunset. Fasting during Ramadan involves abstaining from food, water, beverages, smoking, oral drugs, and sexual intercourse. Although the Quran exempts chronically ill from fasting, many Muslims with diabetes still fast during Ramadan. Patients with diabetes who fast during the month of Ramadan can have acute complications. The risk of complications in fasting individuals with diabetes increases with longer periods of fasting. All patients with diabetes who wish to fast during Ramadan should be prepared by undergoing a medical assessment and engaging in a structured education program to undertake the fast as safely as possible. Although some guidelines do exist, there is an overwhelming need for better designed clinical trials which could provide us with evidence-based information and guidance in the management of patients with diabetes fasting Ramadan.

Keywords

Diabetes mellitus - fasting - Islam - Ramadan


Publication History

Article published online:
09 August 2021

© 2014. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Niazi AK, Kalra S. Patient centred care in diabetology: An Islamic perspective from South Asia. J Diabetes Metab Disord 2012;11:30.
  • 2 Bravis V, Hui E, Salih S, Mehar S, Hassanein M, Devendra D. Ramadan Education and Awareness in Diabetes (READ) programme for Muslims with Type 2 diabetes who fast during Ramadan. Diabet Med 2010;27:327-31.
  • 3 Al-Arouj M, Assaad-Khalil S, Buse J, Fahdil I, Fahmy M, Hafez S, et al. Recommendations for management of diabetes during Ramadan: Update 2010. Diabetes Care 2010;33:1895-902.
  • 4 Hitman GA. Fasting, Ramadan and diabetes. Diabet Med 2012;29:695.
  • 5 The Holy Quran 2:183-5.
  • 6 Chamsi-Pasha H, Albar MA. Fasting Ramadan from Islamic and Medical Perspective. Jeddah: Al-Dar Al-Saudia; 2005.
  • 7 Salti I, Bénard E, Detournay B, Bianchi-Biscay M, Le Brigand C, Voinet C, et al. 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;27:2306-11.
  • 8 Ghouri N, Gatrad R, Sattar N, Dhami S, Sheikh A. Summer-winter switching of the Ramadan fasts in people with diabetes living in temperate regions. Diabet Med 2012;29:696-7.
  • 9 Hui E, Bravis V, Hassanein M, Hanif W, Malik R, Chowdhury TA, et al. Management of people with diabetes wanting to fast during Ramadan. BMJ 2010;340:c3053.
  • 10 Karamat MA, Syed A, Hanif W. Review of diabetes management and guidelines during Ramadan. J R Soc Med 2010;103:139-47.
  • 11 Beshyah SA. Fasting during the month of Ramadan for people with diabetes: Medicine and Fiqh united at last. Ibnosina J Med Biomed Sci 2009;1:58-60.
  • 12 Hui E, Devendra D. Diabetes and fasting during Ramadan. Diabetes Metab Res Rev 2010;26:606-10.
  • 13 Van de Laar FA, Lucassen PL, Akkermans RP, Van de Lisdonk EH, Rutten GE, Van Weel C. Alpha-glucosidase inhibitors for type 2 diabetes mellitus. Cochrane Database Syst Rev 2005;2:CD003639.
  • 14 Pan C, Yang W, Barona JP, Wang Y, Niggli M, Mohideen P, et al. Comparison of vildagliptin and acarbose monotherapy in patients with Type 2 diabetes: A 24-week, double-blind, randomized trial. Diabet Med 2008;25:435-41.
  • 15 Retnakaran R, Zinman B. Thiazolidinediones and clinical outcomes in type 2 diabetes. Lancet 2009;373:2088-90.
  • 16 Bashir MI, Pathan MF, Raza SA, Ahmad J, Khan AK, Ishtiaq O, et al. Role of oral hypoglycemic agents in the management of type 2 diabetes mellitus during Ramadan. Indian J Endocrinol Metab 2012;16:503-7.
  • 17 Belkhadir J, el Ghomari H, Klöcker N, Mikou A, Nasciri M, Sabri M. Muslims with non-insulin dependent diabetes fasting during Ramadan: Treatment with glibenclamide. BMJ 1993;307:292-5.
  • 18 Rendell M. The role of sulphonylureas in the management of type 2 diabetes mellitus. Drugs 2004;64:1339-58.
  • 19 Glimepiride in Ramadan (GLIRA) Study Group. The efficacy and safety of glimepiride in the management of type 2 diabetes in Muslim patients during Ramadan. Diabetes Care 2005;28:421-2.
  • 20 Velayudhan M. Managing diabetes during the Muslim fasting month of Ramadan. Med J Malaysia 2012;67:353-4.
  • 21 Mafauzy M. Repaglinide versus glibenclamide treatment of Type 2 diabetes during Ramadan fasting. Diabetes Res Clin Pract 2002;58:45-53.
  • 22 Pathan MF, Sahay RK, Zargar AH, Raza SA, Khan AK, Siddiqui NI, et al. South Asian Consensus Guideline: Use of GLP-1 analogue therapy in diabetes during Ramadan. Indian J Endocrinol Metab 2012;16:525-7.
  • 23 Devendra D, Gohel B, Bravis V, Hui E, Salih S, Mehar S, et al. Vildagliptin therapy and hypoglycaemia in Muslim type 2 diabetes patients during Ramadan. Int J Clin Pract 2009;63:1446-50.
  • 24 Hanif W, Malik W, Hassanein M, Kamal A, Geransar P, Andrews C, et al. Treatment adherence with vildagliptin compared to sulphonylurea as add-on to metformin in Muslim patients with type 2 diabetes mellitus fasting during Ramadan. Curr Med Res Opin 2013;29:807-11.
  • 25 Al-Arouj M, Hassoun AA, Medlej R, Pathan MF, Shaltout I, Chawla MS, et al. The effect of vildagliptin relative to sulphonylureas in Muslim patients with type 2 diabetes fasting during Ramadan: The VIRTUE study. Int J Clin Pract 2013;67:957-63.
  • 26 Al Sifri S, Basiounny A, Echtay A, Al Omari M, Harman-Boehm I, Kaddaha G, et al. The incidence of hypoglycaemia in Muslim patients with type 2 diabetes treated with sitagliptin or a sulphonylurea during Ramadan: A randomised trial. Int J Clin Pract 2011;65:1132-40.
  • 27 Aravind SR, Ismail SB, Balamurugan R, Gupta JB, Wadhwa T, Loh SM, et al. Hypoglycemia in patients with type 2 diabetes from India and Malaysia treated with sitagliptin or a sulfonylurea during Ramadan: A randomized, pragmatic study. Curr Med Res Opin 2012;28:1289-96.
  • 28 Al-Khawari M, Al-Ruwayeh A, Al-Doub K, Allgrove J. Adolescents on basal-bolus insulin can fast during Ramadan. Pediatr Diabetes 2010;11:96-100.
  • 29 Benbarka MM, Khalil AB, Beshyah SA, Marjei S, Awad SA. Insulin pump therapy in Moslem patients with type 1 diabetes during Ramadan fasting: An observational report. Diabetes Technol Ther 2010;12:287-90.
  • 30 Hui E, Reddy M, Bravis V, Rahman M, Darko D, Hassanein M. Fasting among pregnant women with diabetes during Ramadan. Int J Clin Pract 2012;66:910-1.
  • 31 Kridli SA. Health beliefs and practices of Muslim women during Ramadan. MCN Am J Matern Child Nurs 2011;36:216-21.