Managing diabetes in people fasting during Ramadan

Diabetes & Primary Care Vol 13 No 3 2011 Fasting in Ramadan (Sawm) is one of the five pillars of Islam. The other pillars are: Shahada (the declaration of faith), Salah (five daily prayers), Zakat (annual alms tax) and Hajj (pilgrimage to Mecca). The Muslim population in the UK is estimated close to 1.6 million people, constituting 2.7% of the overall population (Office for National Statistics, 2001). While diabetes affects 4% of the white Caucasian population, it affects 22–27% of some ethnic groups’ Muslim population between the ages of 25 and 74 years (Hanif et al, 2007). The approximate number of Muslims with diabetes in the UK is estimated at 325 000 (Watkins, 2002). Although the Holy Quran exempts people with chronic diseases from fasting, there are many people with diabetes who still choose to fulfil their religious beliefs. Fasting may lead to hypoglycaemia or hyperglycaemia, or both, with or without ketoacidosis. In the past, healthcare professionals have advised people not to fast and, because of this, some people have been reluctant to seek medical advice. However, attitudes are changing as more information is available to help educate healthcare professionals about the cultural aspects of diabetes care.