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 Ramadan is the ninth month of the Muslim (lunar) calendar, when the
Quran was first revealed to Muhammed, according to Islamic doctrine.
The month is calculated to begin this year on June 18 in most
countries.
Muslims around the world observe Ramadan by fasting from dawn until
sunset. While people with diabetes are exempted from fasting under
Islamic law, many still choose to do so, said Dr. Mahmoud Ibrahim,
an endocrinologist and the director of the Diabetes Education Center
in McDonough, Georgia.
“Our mission is not to ignore them but trying to help them achieve
safer fasting as much as we can,” he said in a telephone interview.
According to Ibrahim, fasting during Ramadan poses two types of risk
to people with type 2 diabetes, sometimes called adult-onset
diabetes. First are complications such as low blood sugar, high
blood sugar, ketoacidosis (a metabolic imbalance that can be fatal),
dehydration, and blood clots. Second, Muslims who observe Ramadan
often feast after breaking their fast, which can lead to weight
gain.
“The decision to fast is actually an interplay between three major
players—the person himself, his religious leader, and the medical
advisor,” Ibrahim said. “All people with type 1 diabetes or who need
insulin should not fast, any underaged child should not fast, and of
course any women who are diabetic and pregnant should not fast at
all.”
The ADA recommends that people with type 2 diabetes who choose to
fast during Ramadan receive education on how to achieve a safer
fast. At the ADA meeting, Dr. Ibrahim presented the results of his
study in 774 men and women with type 2 diabetes who planned to fast
last year during Ramadan. Study participants attended one of 16
different clinics in Egypt, Iran, Jordan and Saudi Arabia. Half of
the clinics provided an individualized education program to study
participants, while the other half provided usual care.
The education program addressed meal planning, physical activity,
blood glucose monitoring, and acute metabolic complications, and
provided an individualized diabetes treatment plan.
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After Ramadan, Ibrahim and his team found that study participants
who received individualized education were more likely to have
modified their treatment during Ramadan, to monitor their blood
sugar at least twice a day, and to have better knowledge of the
signs and symptoms of hypoglycemia. They also reduced their body
mass index significantly, and improved their blood glucose control.
The education program group had more mild and moderate episodes of
hypoglycemia, but fewer severe episodes.
Ibrahim stressed that he and his colleagues only enrolled people who
were not on insulin in the study, and did not have any complications
of diabetes.
The full results of Ibrahim’s study have been published in the
British Medical Journal.
SOURCE: http://bit.ly/1Fn3o94 BMJ, online June 16, 2015.
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