Ramadan fasting and the medical patient: Consensus is welcome but more evidence is needed

Sherif, Ibrahim H.; Lakhdar, A.

doi:10.4103/1947-489x.211003

Cited by 22 publications

(23 citation statements)

References 3 publications

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“…Patients' tendency to avoid attending clinics during Ramadan was documented previously in diabetes, pediatric and antenatal practices (14)(15)(16). Notwithstanding this, the exploratory nature of the present study remains a valuable contribution to the literature (17). Furthermore, detailed pump data and actual insulin doses should have been captured even in such small numbers of patients.…”

Section: Discussionmentioning

confidence: 71%

Experience with diabetic adolescents observing ramadan fasting

Musleh

Beshyah

Awad

et al. 2015

Ibnosina Journal of Medicine and Biomedical Sciences

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Background and Aims: Fasting during the holy month of Ramadan is an obligatory duty for all healthy adult Muslims. Fasting can be a major challenge for adolescents with type 1 diabetes mellitus (T1DM) as they have to keep good glycemic control to avoid complications. Limited data was published regarding the safety of fasting Ramadan in adolescent patients with T1DM. We have therefore conducted this study addressing the question “Can adolescents with T1DM fast safely during the Holy month of Ramadan, without getting significant hypo/hyperglycemia?” Patients and Methods: This is an observational, prospective, single center study, conducted during Ramadan 2013. Twenty-three patients were observed (7 males, 16 females). Median age was 14 years. All of them had T1DM, and were planning to observe the fast during Ramadan. They were provided with dairies to be filled by the parents or the adolescents themselves (with parental supervision), indicating the days they fasted/didn't fast, and the reasons for not fasting e.g. hypoglycemia, hyperglycemia, menstrual period, sickness or other reasons. Patients were also asked to record the blood glucose readings and their insulin doses on daily basis. They were asked to bring their folders back to the Diabetic clinic after Ramadan. Outcome measures obtained included the percentages of the days fasted/not-fasted, the reasons for not fasting, HbA1c changes, and a comparison between patients on multiple daily injections and those on insulin pump. Moreover, we studied the relationship between the number of days not-fasted due to diabetes related issues and the HbA1c before Ramadan. Results: Patients were able to fast 79.9% of the total days eligible for fasting, while 20.1% of the days were not fasted due to either hypoglycemia (29.1%), hyperglycemia (19.4%) or other reasons (51.5%). None of the patients developed severe hypoglycemia or diabetic ketoacidosis. There was a mild increment in mean HbA1c after Ramadan (from 8.3% to 8.5%). The patients on insulin pump tended to fast more days than those taking multiple daily injections (82.8% versus 77.3% out of the total eligible days). Patients who had able to fast more days without diabetes related problems tended to have had a marginally better glycemic control before Ramadan (8.3% versus 8.7%). Conclusions: Adolescent patients with T1DM wishing to fast during the holy month of Ramadan may contemplate doing this under medical supervision. The use of insulin pump therapy may help patients to fast more easily and have better control. Adequate education and good glycemic control prior to Ramadan is associated with better outcome.

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Section: Discussionmentioning

confidence: 71%

Experience with diabetic adolescents observing ramadan fasting

Musleh

Beshyah

Awad

et al. 2015

Ibnosina Journal of Medicine and Biomedical Sciences

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“…[3] Despite the increase in volume of the literature, concern has been voiced regarding the quality of publications on the subject. [4,5] The literature on health aspects of Ramadan fasting (RF) is widely spread in many journals, making it not readily accessible to those interested in the subject. We therefore aimed to provide a thematic overview of the global research work conducted in the realm of RF during 2020 on the impact of RF in people with diabetes.…”

mentioning

confidence: 99%

Ramadan fasting and diabetes (2020): The year in review

Hafidh

Ali

Abbas

et al. 2021

Journal of Diabetes and Endocrine Practice

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Review Article introduCtionRamadan fasting (RF) observed by adult Muslims entails abstinence from food, water, all oral substances, intravenous fluid therapy, and smoking between dawn and sunset during the 9 th month of the Muslims' lunar calendar. [1] Ramadan's impact on health and disease stems from the biological effects of prolonged fasting during the daytime and possible overfeeding at night and its various social changes. The last three decades witnessed a rising interest in the research on RF in health and disease. [2] Diabetes has been the most extensively studied single medical condition in connection with RF. [3] Despite the increase in volume of the literature, concern has been voiced regarding the quality of publications on the subject. [4,5] The literature on health aspects of Ramadan fasting (RF) is widely spread in many journals, making it not readily accessible to those interested in the subject. We therefore aimed to provide a thematic overview of the global research work conducted in the realm of RF during 2020 on the impact of RF in people with diabetes. We aimed to provide a concise bird's eye view of the literature published in a year and to identify the basis of evidence that may guide clinical practices for the years to come. matErials and mEthodsThis is a narrative, nonsystematic review of the literature retrieved from one online database over a full calendar year (2020). The PubMed search engine of the National Center for Biotechnology Information at the U.S. National Library of Medicine was used. The search term ("Ramadan Fasting" OR "Fast of Ramadan") AND diabetes, with time filters from January 1, 2020, to December 31, 2020, was used to identify the relevant records. Retrieved articles were examined forThe literature on health aspects of Ramadan fasting (RF) is widely spread in many journals, making it not readily accessible to those interested in the subject. We aimed to provide a narrative overview of the global literature production in 1 year (2020) on diabetes and RF. This was a narrative, nonsystematic review of the international literature from a single major medical online database (i.e., PubMed) during the year 2020. The search term "Ramadan fasting AND Diabetes" was used, and the relevant literature was narrated in a concise thematic account. The publications spanned a vast array of topics related to RF, including assessments of safety and efficacy profiles of older and newer diabetes therapies, modes of insulin delivery, evaluating the role of utilizing advanced technology for the treatment, and monitoring of blood glucose during RF. Increased interest was evident in capturing patients' perspectives and healthcare professionals' perceptions, attitudes, and practices during Ramadan. Fasting by high-risk groups was studied. Not surprisingly, some reports covered COVID-19 and Ramadan and the role of telemedicine in ramadan. The current literature review presents this year's research data on the safety of fasting practices, care models, and patients' experiences and perspectives....

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“…In conclusion, Muslim children with epilepsy can be actively counseled and guided on the appropriateness of fasting Ramadan if so desired. Suggested characteristics of CWE with low risk for seizure occurrence during Ramadan fasting include a history of controlled epilepsy, AED monotherapy and a classification of partial seizures, but further large scale multicenter studies to confirm this observation are needed (9).…”

Section: Discussionmentioning

confidence: 99%

Ramadan fasting in children with epilepsy: An exploratory study

Fathalla

2014

Ibnosina Journal of Medicine and Biomedical Sciences

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Objective: To observe seizure occurrence during the month of Ramadan among fasting Muslim children with epilepsy who are on treatment with antiepileptic drugs (AEDs). Methods: Prospective observational study of pediatric patients with epilepsy intending to fast in Ramadan of the year 2011 and 2012. Patients identified through pediatric neurology clinic visits in the 3 months prior to Ramadan were asked whether they plan to fast Ramadan or not. They were counseled on medication compliance, medication rescheduling, seizure precautions, and management of breakthrough seizures. Patients were advised against fasting if their epilepsy was not controlled. The outcome was assessed by verbal report on their follow up visit after Ramadan. Results: 20 patients (13 males, 7 females, with age range of 7-14 years, median age 10 years) with 19 reported patient fasting cycles were identified (2 patients fasted on both years, 3 patients did not fast). There were only 2 reported seizures in 19 patient fasting cycles. All patients reported compliance with the medication schedule as directed in the pre-Ramadan visit. There were no reported adverse effects to the new schedule of medication administration. Conclusions: Fasting Ramadan in children with epilepsy appears to be feasible with proper physician guidance and patient compliance. Anticipatory guidance is essential in caring for children with epilepsy who intend to participate in religious based activities that may potentially modify their risk for seizures.

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Ramadan fasting and the medical patient: Consensus is welcome but more evidence is needed

Cited by 22 publications

References 3 publications

Experience with diabetic adolescents observing ramadan fasting

Experience with diabetic adolescents observing ramadan fasting

Ramadan fasting and diabetes (2020): The year in review

Ramadan fasting in children with epilepsy: An exploratory study

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