Fasting in the holy month of Ramadan is one of the five pillars of Islam and is considered a religious obligation for Muslims. While fasting is not required for people with diabetes, one study found that almost 80 percent of all Muslims with type 2 diabetes fast for at least 15 days. (1)
People with diabetes who fast are at a higher risk of complications such as hypoglycemia, hyperglycemia and ketoacidosis due to changes in physiological parameters such as eating patterns and circadian rhythms.
Therefore, health care professionals are responsible for delivering accurate information regarding fasting and diabetes. The foundation for safely managing diabetes during Ramadan is patient education, which should include instructions on expected risks, medication adjustment, glucose monitoring, nutrition and exercise.
Many studies have shown that education before Ramadan reduces hypoglycemic episodes. Education also increases awareness about the importance of regular glucose monitoring to avoid complications, stresses the importance of diet and exercise, and allows for medication adjustments which are necessary with lifestyle changes while fasting.
What should I do before Ramadan?
We strongly advise receiving your pre-Ramadan risk stratification and counselling from your healthcare professionals 6-8 weeks before Ramadan.
At GluCare integrated Diabetes Center diabetes we understand the impact of the religious/cultural practices of our patients on their diabetes and we help them to practice this safely.
What is included in the pre-Ramadan clinical visit?
First, a risk stratification for fasting in patients with diabetes will be completed.
With the pre-Ramadan assessment and screening, we show our patients their individual risk for complications during Ramadan and how to avoid them.
(2) The South Asian Health Foundation (UK) Guidelines for Managing Diabetes during Ramadan: 2020 Update
Abbreviations: CKD, chronic kidney disease; DKA, diabetic ketoacidosis; DPP4, dipeptidyl peptidase; GLP1, glucagon-like peptide; HbA1c, glycosylated haemoglobin; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus.
What is important when it comes to fasting safely during Ramadan?
The key components of managing your diabetes safely through Ramadan include:
- Ramadan Specific Diabetes Education
- How and when to monitor your glucose levels
- How and when to break the fast
- How and when to take your insulin and/or medication
What is Ramadan Specific Diabetes Education:
Ramadan education includes the following:
(3) IDF DAR Practice guidelines 2021
What I can expect from GluCare?
GluCare Integrated Diabetes Center can help you safely manage your diabetes during Ramadan by using Digital Therapeutics and connecting you to our remote monitoring platform. Unlike other providers, we can look at trends, intervene earlier, and provide better predictions to avoid fluctuating blood sugars during Ramadan.
Digital devices such as a Continuous Glucose Monitor (CGM) and our proprietary band can help you and your care team better monitor and adjust your treatment as necessary.
Combining in-clinic visits and a 24/7 monitoring platform, in conjunction with regular remote engagement with our care team, allows us to create individualized management plans ‘pre-Ramadan’ for each of our patients.
During Ramadan we will provide individualized nutritional plans. We will also provide you with insights and advice on medication adjustment without having to physically visit GluCare for each adjustment. You will also receive regular feedback about your glucose values via our chat function.
After Ramadan we discuss medication and regime readjustments back to your normal routine.
With the GluCare Ramadan program, our expertise and digital therapeutics platform will provide you with the ability to manage your diabetes and fast in a safe and engaging manner, throughout the Holy month.
- Salti I, Bénard E, 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 Oct;27(10):2306-11. ncbi.nlm.nih.gov/pubmed/15451892
- The South Asian Health Foundation (UK) Guidelines for Managing Diabetes during Ramadan: 2020 Update, Hanif W, Patel V, Ali SN, Karamat A, Saeed M, Hassanein M, Syed A, Chowdhury TA, Farooqi A, Khunti K
- IDF DAR Practice guidelines 2021