Safe Ramadan Fasting in Patients with Type I Diabetes Mellitus

Abstract

Background All healthy, adult Muslims are obligated to fast from sunrise to sunset for one lunar month each year. During this time, they have to abstain from food, water, beverages, smoking, oral drugs and sexual intercourse. A large multicentred, epidemiological study in 13 Muslim countries also revealed that 43% of people with Type 1 diabetes and 86% of people with Type 2 diabetes observed the fast during Ramadan. Previously, an education programme in London has attempted to provide advice and support locally to Muslim patients with diabetes, who choose to fast during the month of Ramadan. Objective Safety & efficacy of diabetes health education programs in Ramadan fasting in people with T1DM. Methods The study was conducted on 60 Type 1 diabetic patients intended to fast Ramadan 2017 with average fasting hours 16 hrs. The patients were recruited form the Diabetes outpatient clinic at Ain-Sham University hospitals. All participants (60 subjects) received a basic health education program which was based on Conversational MAP (Living with diabetes). Then participants were subdivided into 2 equal groups each of 30 subjects: Group 1 received Modified IDF health education program for Ramadan fasting. Group 2 received Ramadan Conversational MAPS. Only 29 patients in group 1 and 24 patients in group 2 completed the study, while other 7 patients who attended pre-Ramadan health education sessions but were lost to follow up sessions during and after Ramadan, so they were excluded from the study. Conclusion Health education make Ramadan fasting more safe in those patients with type-I diabetes whatever the method of education. Results Speaking of effect of health education programs on safe Ramadan fasting, glycemic control & less frequent hypoglycemic episodes sһowed significant decrease in FBS before and after Ramadan in both study groups witһ a mean difference in FBS are 24.517 mg/dl and 61.833mg/dl IDF & MAPS groups respectively .

Validity of the International Diabetes Federation risk stratification score of Ramadan fasting in individuals with diabetes mellitus

“…Evidence from many previous studies suggests that some T1DM patients can fast safely during Ramadan when they follow medical advice. 10 - 12 …”

“…Evidence from many previous studies suggests that some T1DM patients can fast safely during Ramadan when they follow medical advice. [10][11][12] With the new IDF-DAR stratification score, practitioners can more easily assess fasting risks in diabetic patients. However, it appears that our cohort's healthcare provider did not take advantage of this score, as only 20 patients were advised not to fast, despite 56.9% of them being at high risk and 24.7% at moderate risk.…”