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Year : 2020  |  Volume : 12  |  Issue : 2  |  Page : 98-107

The individualization of care for people with diabetes during ramadan fasting: A narrative review

1 Department of Medicine, United Arab Emirates University; Division of Endocrinology, Tawam Hospital, Al Ain, UAE
2 Department of Medicine, Dubai Medical College, Dubai; The Endocrinology Clinic, Abu Dhabi, UAE
3 Department of Diabetes and Endocrinology, Dubai Health Authority, Dubai Hospital, Dubai, UAE; Cardiff University, Cardiff, Wales, UK
4 Department of Endocrinology, Medcare Hospital; Mohammed Bin Rashid University, Dubai, UAE; Aga Khan University, Karachi, Pakistan
5 Department of Medicine, United Arab Emirates University, Al Ain; Department of Endocrinology, Imperial College London Diabetes Center, Abu Dhabi, UAE

Correspondence Address:
Dr. Bachar O Afandi
Division of Endocrinology, Tawam Hospital, Al Ain
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmbs.ijmbs_49_20

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Management of Muslim people with diabetes who choose to observe the fasting during the holy month Ramadan may become a complicated situation in which neither physicians nor patients have straightforward solutions. While most patients with diabetes fast Ramadan safely, some patients do face potentially life-threatening complications, including hypoglycemia, hyperglycemia, dehydration, and ketoacidosis. Several professional recommendations categorize patients with diabetes as very high/high, moderate, or low-risk groups. This classification was based principally on the type of disease, the status of metabolic control, type of treatment, and modified by the presence of other comorbidities and circumstantial factors. Ramadan clinical recommendations for individuals with diabetes are mainly based on expert opinions with limited, yet growing, scientific evidence, and research. On occasions, they do not take account of many important variables that require a personalized approach. In this narrative perspective, we discuss the individualized management of people with diabetes during Ramadan fasting taking into consideration the hours of fasting during the day, weather, resources, personal patterns of dieting, sleeping and exercise, previous fasting experience, and, most importantly, patient preferences among many other factors. This narration is aimed to encourage physicians to think out of the box and provide an individually-tailored recommendation on whether to fast and how best to modify management plans if fast was deemed safe.

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