Diabetic patients and ramadan fasting: what advice do they get and from whom?

The availability and source of advice to 48 diabetic patients [23 women and 25 men] on Ramadan fasting were surveyed by a semi structured interview. Their mean age was 50[17-72] years. They had had diabetes for 8 [1 to 34] years and six patients had type 1 diabetes. Patients were treated with insulin [n= 14], combination oral therapy [n=25] or mono-therapy [n=6]. Forty two patients confirmed observing the fast and only six did not [2 patients had type 1 diabetes]. Two thirds reported that took their own decisions regarding the fasting and changes of medication and one third got some form of a professional advice [n= 16]. Of these 5 got advice from non diabetic physicians. Majority of the patients described reduction in the medication during Ramadan but details could not be ascertained the exact dose. 17 patients described problems with blood glucose control [hypoglycaemia in 11, hyperglycaemia with and without symptoms in 4 and a mixed picture in 2]. Many patients did not feel the need or relevance of consult their diabetes care team. In conclusion, fasting during Ramadan is commonly observed by Moslem diabetic patients. However, the main cause for concern that that the majority do no seek professional advice on the feasibility or safety of fasting in their individual case nor on the ways medication need to be adjusted during Ramadan. Proactive educational and publicity campaigns before the fasting month should address this issue by raising awareness and making medical advice readily available from the qualified professionals

Care for people with diabetes during the moslem pilgrimage [HAJ] an overview

Haj is one of the five cardinal components of Islam commonly known as the five pillars of Islam. Approximately two million Muslims perform it each year. Haj involves travel to the holy sites in and around Mecca and Medina during a specified short period of time in a limited space, not usually inhabited by such a large number of people. This article deals with the effects of this event on diabetes and its management. The importance of this arises from the fact during Haj, the person's life routine changes as he travels to a different place of his own for a period of 4-6 weeks where geography, weather, diet, and habits are different. During Haj most people live what is effectively a very basic life in very crowded places. Therefore, medical conditions, such as diabetes, whose management depends on a stable routine, would predictably be affected significantly. People with diabetes should have enough time to consider a management plan for their diabetes. The objectives are to achieve a good control and avoid any complications that may be particularly associated with the conditions faced during Haj