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.
Special mention should be made of Ramadan, the holiest month of the Islamic year.1,2 During this period fasting is practised from sunrise (sahur) to sunset (iftar) and this includes abstinence from both food and fluids. The annual timing of Ramadan advances by 10 to 11 days per calendar year and currently falls in the summer months in the northern hemisphere demanding a long duration without oral intake. This year, Ramadan began on 27 June and will end at sunset on 28 July.