Diabetes Mellitus and Ramadan - review

Objective of the review is to find out the management of Diabetes Mellitus in the month of Ramadan. For this review the published literatures on diabetes management during the month of Ramadan in Middle-East are studied with the aim of getting a global picture of the 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 patients and help health care providers curb the tide of the diabetes epidemic. I have searched available articles published in PubMed and Medline primarily by using the key words "Diabetes Mellitus", "Ramadan" and "fasting". I have covered epidemiology, clinical, management and complication profile. Few studies show that Ramadan fasting did not alter clinical, body composition and biochemical parameters. However other studies have shown that there is either an increase or a decrease in clinical and biochemical parameters during Ramadan. 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. It follows from this review that Ramadan fasting is acceptable for well balanced type 2 Diabetes patients conscious of their disease and compliant with their diet and drug intake. Islamic rules allow patients not to fast. However, it patients with diabetes wish to fast, it is necessary to advise them to undertake glycaemia control several times a day to prevent hypoglycemia risks during daytime fasting or hyperglycemia during the night. Patients with type 1 Diabetes who will fast during Ramada may be better managed with fast absorption insulin