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

ABSTRACT

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