Diabetes Mellitus and Ramadan: Physiopathological, Clinical and Therapeutic Aspects

Fasting from dawn to sunset during Ramadan is one of the five pillars of Islam. A significant number of diabetic patients insist on fasting during Ramadan against the recommendations of their physicians. Fasting in diabetic subjects may be associated with increased risk of hypoglycemia and hyperglycemia, diabetic ketoacidosis, dehydration and thrombosis. Patients with uncontrolled diabetes mellitus are predisposed to major metabolic risks. Another problem is the reluctance of diabetic patients in taking their medications during the fast; therefore the timing and the dosage of anti-diabetic drugs must be adapted for each patient. It is important for diabetic patients who wish to fast during Ramadan to effect the necessary preparation to approach the fasting as safely as possible. Up to now, the management of these patients is a challenge for healthcare professionals. The aim of this minireview is that to offer a simple guide for management of Muslim diabetic patient during Ramadan.