This month sees the start of Ramadan, the holiest month of the Islamic year. 1,2 During this period fasting is practised from sunrise to sunset, and this includes abstinence from both food and fluids. Usually two meals are consumed a day, one pre-dawn (Suhoor or Suhur) and one post-sunset (Iftar).
The annual timing of Ramadan (determined by the lunar calendar) advances by 10 to 11 days per (solar) calendar year and currently falls in the summer months in the northern hemisphere demanding a long duration without oral intake. Ramadan in the UK begins on 7 June this year, lasting for 30 days, and it is obligatory for healthy Muslim adults to observe it.
Patients with diabetes can be exempted from fasting. This includes: children; the frail elderly; those treated with insulin; with poorly controlled diabetes or complications; with learning difficulties and those who are pregnant or breast feeding.3 Specific advice can be sought from the local Imam who might suggest an alternative way of respecting Ramadan.
But many Muslims with diabetes feel committed to Ramadan and one study estimated that up to 79% of patients with type 2 diabetes and 43% of patients with type 1 diabetes fast during this period.4 These patients need good medical advice.