Managing patients with diabetes during fasting times

Fasting is practised throughout the world for spiritual, psychological and physical benefits. Maintaining health and safety in the fasting patient with diabetes can be challenging. This is particularly the case in the frail elderly, in the presence of comorbidities and with treatments predisposing to hypoglycaemia, notably sulfonyl- ureas and insulins.

Nurses involved in the care of patients with diabetes need to be able to advise on the risks associated with fasting and how best to manage these. This may include advice on diet, exercise and medication, and action patients can take should complications arise. There may be strong medical reasons why fasting would be inadvisable, but ultimately the decision whether to fast or not lies with the patient. The nurse's remit is to inform the patient.