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Evidence revealed that Fasting for Type 1 Diabetes might be harmful?
- samia alhabib (23 September 2007)
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Ramadan Fasting and Diabetes in Pregnancy
- Joan Melendez, Aziz Abed (26 September 2007)
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Post prandial hyperglycemia
- Ali K Kamona (5 October 2007)
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samia alhabib, GP W7 1JJ
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A large epidemiological study conducted in 13 Islamic countries on 12,243 individuals with diabetes who fasted during Ramadan showed a high rate of acute complications (Salti 2004, Diabetes care). There is a fivefold increase in the incidence of severe hyperglycemia (requiring hospitalization) during Ramadan with or without ketoacidosis in patients with type 1 diabetes. In addition patients with diabetes, especially those with type 1 diabetes, who fast during Ramadan are at increased risk for development of diabetic ketoacidosis, particularly if they are grossly hyperglycemic before Ramadan. Furthermore, less fluid intake and hot climate may lead to dehydration. I aggre that fasting for patients with diabetes is a personal decision, provided he or she is well informed of the risks. Patients may be at higher or lower risk for fasting-related complications depending on the number and extent of their risk factors. Competing interests: None declared |
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Joan Melendez, SHO in Obs & Gynae North Middlesex Hospital N18 1QX, Aziz Abed
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After reading the article Ramadan Fasting and Diabetes by Professor Aziz Sheikh we felt the need to share our professional experience on this matter. We work in an area which is very multicultural and where the Muslim population is highly represented. In the Obstetrics department we provide daily antenatal care to various women. Depending on a patient’s previous medical history and obstetric history, some women are considered to be high risk pregnancy. Women who are known diabetics or those who develop gestational diabetes are included in this group. As doctors we advise pregnant women with gestational diabetes to have regular meals throughout the day to maintain optimum glucose control, especially when medical treatment is required such as insulin and antidiabetic drugs. During the month of Ramadan, it not unusual to be asked questions by Muslim women regarding their diabetes and fasting which forbids any food or drinks from sunrise to sunset. In order to respect religious and cultural practices by women of the Muslim faith, doctors must do the best they can to provide the care needed by adjusting and monitoring the dosages and times throughout the day in which the drugs can be administered. More importantly, a doctor must convey to the patient the risks of not following a balanced diet or not taking the required drugs. We respect and agree that fasting in Ramadan is a personal decision. We understand our duty is to provide information and the necessary care, but we cannot deny there are risks in fasting when pregnant and complications to be aware of. Competing interests: None declared |
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Ali K Kamona, Staff Grade physician Ashford hospital,Middlesex TW15 3AA
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Patients with diabetes are at a higher risk of complications because of the postprandial hyperglycemia.Many studies have shown that.The DECODE(Diabetic Epidemiology Collaborative analysis of Diagnostic Criteria in Europe)have clearly shown that glucose level 2 hours after an oral challenge of glucose is powerful predictor of cardiovascular risk.Many other studies have shown that. Most fasting people will not tolerate a large meal when they break their fast.Some of them,however,will have a large meal and continue to eat throughout the evening. This issue must be kept in mind and made clear to the diabetic during the consultation. Competing interests: None declared |
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