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Year : 2012  |  Volume : 4  |  Issue : 4  |  Page : 137-146

Management of common endocrine conditions other than diabetes mellitus during ramadan fasting

1 Center for Diabetes and Endocrinology, Institute of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
2 Department of Medical Subspecialties, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates

Correspondence Address:
Salem A Beshyah
Center for Diabetes and Endocrinology, Institute of Medicine, Sheikh Khalifa Medical City, Abu Dhabi
United Arab Emirates
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1947-489X.210770

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Patients with any endocrine condition wishing to observe the fasting during Ramadan may seek advice from their primary care or specialist physician. In healthy people, there are minimal changes in the metabolic and hormonal parameters during fasting. However, management of common endocrine conditions may need some adjustments. Aside from diabetes mellitus, endocrine and metabolic conditions commonly seen in clinical practice include hypothyroidism, hyperthyroidism, adrenal disease, pituitary diseases and obesity. Adjustments in medications are based on physiological and clinical aspects of these conditions, and on sound knowledge of the pharmacological characteristics of all prescribed medications. Thyroid hormones should be taken on an empty (or near empty) stomach and not be followed by food by 0.5-1 hour according to the patient's life style. Glucocorticoids should be taken in the same manner at either end of the fasting period, or changed to an extended release preparation taken on its own or in combination with hydrocortisone with Iftar. Management of hypogonadism is essentially the same both during and outside of Ramadan in both men and women. Growth hormone may be taken in the same manner in both children and adults. Patients with diabetes insipidus should be careful with fluid balance, and take adequate doses of desmopresin in widely spaced dosing for maximum benefit. Spontaneous hypoglycemia may present for the first time during Ramadan, and suggestive symptoms should alert the physician to this diagnosis. Ramadan- type intermittent fasting provides an opportunity for weight loss but this is often lost as evening time feasting seems to offset any benefit from daytime fasting. In conclusion, common endocrine conditions are managed along the same lines of good clinical practice, sound understanding of physiology and pharmacology, coupled with modern approaches of individualized and ethnically competent care.

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