Ramadan and Diabetes: A Narrative Review and Practice Update

Area of Science:

• Endocrinology and Metabolic Diseases
• Public Health and Epidemiology
• Religious Studies and Bioethics

Background:

• Ramadan fasting is obligatory for Muslims, with daily fasting durations varying by season and location.
• Individuals with diabetes mellitus (type 1 and type 2) often have an intense desire to fast, even when at high risk.
• The synodic Islamic calendar causes Ramadan to shift through seasons over a 33-year cycle, impacting fasting duration.

Purpose of the Study:

• To review scientific and clinical evidence on fasting in patients with diabetes mellitus during Ramadan.
• To provide recommendations for managing diabetes patients during Ramadan, considering religious sensitivities and health risks.
• To explore the role of technology and therapeutic options in supporting diabetic individuals who choose to fast.

Main Methods:

• Comprehensive review of current scientific and clinical evidence regarding diabetes management during Ramadan.
• Analysis of risk stratification strategies for patients with diabetes before Ramadan.
• Examination of available therapeutic options, including insulin delivery and glucose monitoring technologies.

Main Results:

• Many diabetes patients adopt a self-management approach during Ramadan, often underestimating risks.
• Pre-Ramadan assessment is vital for risk stratification (low to very high risk) and appropriate counseling.
• COVID-19 pandemic has elevated many high-risk diabetes patients to very high risk, advising against fasting.

Conclusions:

• Personalized risk assessment and counseling are essential for safe Ramadan fasting in diabetes patients.
• Close monitoring and support are necessary for individuals who choose to fast against medical advice.
• Ramadan fasting can be an opportunity for patient engagement to improve diabetes management and promote sustainable healthy habits.