Abstract
Background
Fasting in the holy month of Ramadan is among the five pillars of Islam and is considered
as a religious obligation by the Muslim population. People with diabetes observing
the practice of fasts are at a higher risk of complications such as hypoglycaemia,
hyperglycaemia and ketoacidosis due to changes in eating patterns and circadian rhythms.
With the objective of mitigating these complications, the South Asian Health Foundation
(UK) has developed the present guidelines based on robust evidence derived from epidemiological
studies and clinical trials.
Methods
We have highlighted the role of pre-Ramadan risk stratification and counselling by
healthcare professionals with emphasis on the need for advice on adequate dietary
and fluid intake, blood glucose monitoring and awareness of when to break the fast.
Results
We reviewed the current literature and have given clinically-relevant recommendations
on lifestyle modifications and glucose-lowering therapies such as metformin, sulphonylureas,
dipeptidyl peptidase-4 inhibitors, sodium glucose co-transporter-2 inhibitors, thiazolidinediones,
glucagon-like peptide-1 receptor agonists and insulin.
Conclusions
An individualised patient-centric treatment plan is essential to not only achieve
optimal glycaemic outcomes but also enable people with diabetes to observe a risk-free
month of fasting during Ramadan.
Keywords
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Article info
Publication history
Published online: April 23, 2020
Accepted:
April 4,
2020
Received:
March 25,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
