Diabetes Mellitus and Ramadan Fasting

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Diabetes Mellitus and Ramadan Fasting
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Ramadan Fasting and Diabetes Mellitus. The objective of this review article is to assist physicians who face the difficult task of advising diabetic patients about the safety of fasting

Ramadan Fasting and Diabetes Mellitus
10/31/2002 – Education – Article Ref: RR0210-1777 Number of comments: 13 By: Fereidoun Azizi, MD, and Behnam Siahkolah, MD Intl. Journal of Ramadan Fasting Research* From Islamicity.com

The objective of this review article is to assist physicians who face the difficult task of advising diabetic patients about the safety of fasting during the Islamic month of Ramadan. There have been diverse findings regarding the physiological impact of Ramadan on diabetics. However, researchers have not found pathological changes or clinical complications in any of the following parameters in diabetics who fast: body weight, blood glucose, HbA1C, c-peptide, insulin, fructoseamine, cholesterol and triglycerides. In the guidelines section of the article, we strongly recommend diabetic patients continue their regular daily activity and diet regimen. It is also critical that diabetics adjust their drug treatments, particularly those patients diagnosed with insulin dependent diabetes mellitus (IDDM). We named these three important factors — drug regimen adjustment, diet control and daily activity — the "Ramadan 3D Triangle." With 3D attention, proper education and diabetic management, we conclude that most non-insulin dependent diabetes mellitus (NIDDM) patients and occasional IDDM patients who insist on fasting can carefully observe Ramadan. Int J Ramadan Fasting Res. 2:8-17, 1998.

INTRODUCTION Several of the world’s great religions recommend a period of fasting or abstinence from certain foods. Of these, the Islamic fast during the Muslim month of Ramadan is strictly observed every year. Islam specifically outlines one full month of intermittent fasting. The experience of fasting is intended to teach Muslims self-discipline and self-restraint and remind them of the plight of the impoverished. Muslims observing the fast are required to abstain not only from eating and drinking, but also from consuming oral medications and intravenous nutritional fluids. The month of Ramadan contains 28 days to 30 days. The dates of observance differ each year because Ramadan is set to a lunar calendar. Fasting extends each day from dawn until sunset, a period which varies by geographical location and season. In summer months and northern latitudes, the fast can last up to 18 hours or more. Islam recommends that fasting Muslims eat a meal before dawn, called "sahur." Individuals are exempt from Ramadan fasting if they are suffering from an illness that could be adversely affected by fasting. They are allowed to restrain from fasting for one day to all 30 days, depending on the condition of their illness. People diagnosed with diabetes fall into this category and are exempt from the fasting requirement, but they are often loathe to accept this concession. Physicians working in Muslims countries and communities commonly face the difficult task of advising diabetic patients whether it is safe to fast, as well as recommending



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