Diabetes mellitus and Ramadan. A narrative review of literature

Abstract

Background: The medical ramification of fasting among patients with diabetes is largely unknown; the
purpose of the review is to find out how diabetes mellitus is managed during the month of Ramadan.
Methods: Literature published on diabetes management during the month of Ramadan in the Middle-East
are aimed at getting a global picture of this condition at a time when diabetes is having an adverse effect on
health care delivery. I hope the review will be a useful and comprehensive source on the subject (diabetes
mellitus) for researchers, academics and clinicians who care for the increasing number of diabetic patients
and help health care providers curb the tide of the diabetes epidemic. The search includes available articles
published, by using the keywords “Diabetes Mellitus”, “Ramadan” and “fasting” covering epidemiology,
clinical, management and complication profile.
Results: Studies have shown that fasting among diabetic patients carries the potential risk of dangerous
hypoglycaemia and hyperglycaemia, diabetic ketoacidosis and thrombosis. The EPIDIAR study was the
largest study where 50% of the whole sample changed their treatment and hypoglycemia was the only
observed event. There are also few studies which evaluated specific management modalities.
Conclusion: It follows from this review that Ramadan fasting is acceptable for well balanced diabetic
patients, conscious of their disease and compliant with their diet and drug intake. Patients willing to fast
must be advised to undertake control of their glycaemia several times a day to prevent hypoglycemia risks
during daytime fasting or hyperglycemia during the night.