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Fasting is undertaken by people of many religions and cultures and in people with diabetes such a change in eating pattern without adjustment of therapy may worsen glycaemic control and result in complications, including hypoglycaemia, hyperglycaemia and ketosis.
Fasting in Ramadan is a duty on all Muslims above the age of puberty and they are
to abstain from eating, drinking, taking oral medicines between dawn and dusk. Fasting
can last 7-
The Holy Koran specifically exempts those with chronic illness from fasting, even so many muslims with diabetes do fast. Fasting patients with diabetes should monitor blood glucose concentration frequently, particularly if they take insulin. The fast should be broken immediately if the individual becomes hypoglycaemic, (blood glucose concentration below 3.3 mmol/l, or below 3.9 mmol/l during the first hours of the fast). If blood glucose concentration exceeds 16.7 mmol/l, the fast should also be broken to allow the concentration to be brought under control.
Patients with diabetes who fast should eat a healthy balanced diet. In particular,
they should avoid eating large amounts of food at the break of the fast. Instead,
they should take two or three smaller meals in the non-
The pre-
A randomised control trial showed no advantage when Repaglinide was compared to Glibenclamide in 235 Ramadan fasting patients with Type 2 diabetes.
Insulin Lispro has theoretical advantages over standard insulin therapy, but limited trials have not shown clinical advantage to warrant a change of insulin during Ramadan.
Fasting
