Fasting with diabetes during Ramadan: An updated review

Abstract

Introduction: In reality, many Muslims have an intense spiritual urge to participate in fasting, even those who could get an exemption. There are many cultural variations in the Muslim population in different parts of the world, even in the same country with different social and family backgrounds. Thus, persons with diabetes should seek medical advice before planning to fast or proceed to fast during Ramadan.

Materials: This was a narrative, non-systematic review of the international literature from the major medical online database (PubMed and Google Scholar) in 2023. The term “Ramadan fasting” and “Diabetes” was used to search, and the relevant literature was captured and narrated in a concise thematic account.

Results: Practically, there are certain risks associated with fasting for patients with diabetes, which might exacerbate their existing illnesses. Along with the globally increasing prevalence of diabetes, there is an increased number of the population who intend to or fast. The article captured a wide array of topics related to Ramadan fasting by patients with diabetes, including its epidemiology, risk stratification, lifestyle modification, assessment of safety and efficacy profiles of pharmacotherapies, hypo or hyperglycemia, and the impact of diabetes education.

Conclusion: Fasting with diabetes poses a range of risks and thus pre-Ramadan risk stratification is essential. Particular attention should focus on the patient’s current risk factors, complications, comorbidities, and the roles of newer antihyperglycemic medicines and advanced technology for safer fasting practices to mitigate the risks of hypoglycemia and or hyperglycemic crises.