This Year Ramadan starts on 15 May. The Holy month of Ramadan runs for 30 days. The Koran mandates fasting during the month of Ramadan from sunrise to sunset. Fasting during Ramadan is an obligatory duty for all healthy adult Muslims. Ramadan is a period of prayer, fasting, charity-giving and self-accountability for Muslims. Most Muslims living with diabetes will take part in Ramadan even though they may be exempt from doing so.
Fasting during Ramadan for patients with diabetes carries a risk of an assortment of complications such as hypoglycaemia, hyperglycaemia, dehydration and thrombosis. A patient's decision to fast should be made after ample discussion with a health care provider concerning the risks involved. People living with diabetes who insist on fasting should undergo pre-Ramadan assessment.
This is the right time to carry the assessment and this should include a full annual review including measurement of lipids, blood pressure, glycaemic levels and detection of complications. They should receive appropriate education and instructions related to physical activity, meal planning, glucose monitoring, and adjustment of dosage and timing of medications and insulin. The education should also cover the symptoms of hyper and hypo glycaemia. Ensure those at high risk have the appropriate blood monitoring equipment and know how often they should check their sugar levels and how to respond appropriately to cut off points considered high and low levels of blood glucose. Encouraged to break the fast if they experience problems.
Dose of insulin or medication should be adjusted and accordingly. Where possible encourage them to do a small run of fasting before Ramadan. Those who are not able to fast can contribute to a charity or provide food to the poor. They can discuss this with their Imam.
Raising the general awareness of Ramadan and diabetes strengthens the harmony between medical and religious advice. Greater understanding regarding the religious context and perspective regarding Ramadan and the act of fasting, as well as the potential risks and the medical options to achieve a safer outcome for those who wish to fast, is critical for people living with diabetes to fast safely.