Diabetes during Ramadan: underestimated, under-investigated, needs more attention.

OBJECTIVE In Ramadan, Muslims adults fast from sunrise to sunset for a period of a month. Due to paucity of data it seems that, diabetes mellitus during Ramadan is underestimated and the statistics are not a reflection of the actual reality. The aim this study is to highlight the staggering demographics in the diabetic Muslim population and emphasize its ramifications on fasting during Ramadan. METHODS In this study, we identified 37 published studies through a systematic database searches including ISI-Web of Science and PubMed. We searched the related literature by using the key words Diabetes Mellitus, Ramadan Fasting, Ramadan Fasting complications. Studies in which Diabetes Mellitus, Ramadan Fasting was discussed were included in the study. No limitations on publication status, study design or language of publication were obligatory. Finally we included 19 publications and remaining 18 were excluded. RESULTS Today's emerging diabetes hotspots in Muslim majority countries are the Middle East, Western Pacific, Sub-Saharan Africa and South-East Asia. Poverty, lack of education, poor healthcare, minimum available data and inappropriate guidance for the diabetic patients are the major risk factors resulting in serious complication during fasting in the month of Ramadan. CONCLUSIONS Still there are big gaps in the management of diabetic patients during Ramadan, the care of diabetic patients is fragmented and it is felt that diabetes during Ramadan is underestimated, under-investigated and needs more attention. It is vital to empower the healthcare workers and the patients in the frontlines with the appropriate information about Ramadan fasting in diabetic patients. Diabetic patients who fast during Ramadan should be adequately investigated and engaged in a structured Ramadan-focused diabetes education to undertake the fast safely.