Caring for Muslim patients who fast during Ramadan.

A collection of Curbside Consultation published in AFP is available at http://www.aafp.org/afp/ curbside. Case Scenario A 68-year-old Muslim man who was recently diagnosed with type 2 diabetes mellitus presented for a routine health visit. His initial A1C level was 8.2%, which decreased to 6.7% after dietary changes, exercise, and treatment with metformin (Glucophage). He stated that he wanted to fast during Ramadan and requested advice on how to manage his diabetes while fasting. Because our clinic serves a large Muslim community, we have been seeking more general guidelines for advising vulnerable individuals and patients with medical conditions on a safe approach to fasting. What recommendations should we make to patients to maintain health while fasting during Ramadan?