“Risk approach strategy” in diabetics on fasting-evidence base through narrative review with a special focus on Ramadan fasting

Abstract

The past two decades have seen a rise in the number of investigations examining the health-related effects of religiously motivated fasts. The fact that fasting is a common religious practice observed not only among Muslims, but among many other religious communities as well underlie a long felt need for drafting recommendations on fasting in diabetic patients as there are no substantial guidelines for the same. An extensive review of the work involving studies across populations in India and other nations across the world was conducted, with the aim to arrive at some broad consensus highlighting on the need for developing strict guidelines for patients with diabetes during fasting, before fasting and afterwards.

Diabetes - fasting - guidelines - Ramadan - religious - review - risk approach strategy

• References

• 1 Diabetes fact sheet. Available from: http://www.who.int/mediacentre/factsheets/fs312/en/ [Last accessed on 2014 Mar 4].
• 2 Fasting and Diabetes. Available from: http://www.diabetes.org.uk/Documents/Languages/English/Fasting_and_diabetes.pdf [Last accessed on 2014 Feb 17].
• 3 Fasting in religion. Available from: http://www.altreligion.about.com/od/ritualsandpractices/a/Fasting-In-Religion.htm [Last accessed on 2014 Mar 04].
• 4 Trepanowski JF, Bloomer RJ. The impact of religious fasting on human health. Nutr J 2010; 9: 57
• 5 Care of diabetes in people of south Asian origin. Diabetes digest. Available from: http://www.hkmj.org/article_pdfs/hkm0003p53.pdf [Last accessed on 2014 Jul 06].
• 6 International Meeting on Diabetes and Ramadan Recommendations: Edition of the Hassan II Foundation for Scientific and Medical Research on Ramadan. Casablanca, Morocco: FRSMR; 1995
• 7 Salti I, Bénard E, Detournay B, Bianchi-Biscay M, Le Brigand C, Voinet C. et al. A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries: Results of the epidemiology of diabetes and Ramadan 1422/2001 (EPIDIAR) study. Diabetes Care 2004; 27: 2306-2311
• 8 Al-Arouj M, Bouguerra R, Buse J, Hafez S, Hassanein M, Ibrahim MA. et al. Recommendations for management of diabetes during Ramadan. Diabetes Care 2005; 28: 2305-2311
• 9 Rashed AH. The fast of Ramadan. BMJ 1992; 304: 521-522
• 10 Koran. Available from: http://www.quran.com/2/183-185 [Last accessed on 2014 Jul 06].
• 11 Diabetes and fasting in Ramadan: Can we provide evidence based advice to patients?. Available from: http://www.smj.eg.net/journals/pdf/140.pdf [Last accessed on 2014 Feb 28].
• 12 Fatim J, Karoli R, Chandra A, Naqvi N. Attitudinal determinants of fasting in type 2 diabetes mellitus patients during Ramadan. J Assoc Physicians India 2011; 59: 630-634
• 13 Akbani MF, Saleem M, Gadit WU, Ahmed M, Basit A, Malik RA. Fasting and feasting safely during Ramadan in the diabetic patient. Practical Diabetes Int 2005; 22: 100-104
• 14 Whitelaw D. Management of diabetes during Ramadan. Diabet Med 2005; 22 (Suppl. 04) 21-23
• 15 Faith and fasting with diabetes. Available from: http://www.thegrio.com/2012/07/20/faith-and-fasting-with-diabetes [Last accessed on 2014 Feb 17].
• 16 Self Monitoring of Blood Glucose. Harrison′s Principles of Internal Medicine. 17. McGraw-Hill publishers; 2012: 2991
• 17 Permissible?: Getting Blood Draw for Routine Test During Ramadan. Available from: http://www.islamicaweb.com/forums/topic/17209-permissable-getting-blood-draw-for-routine-test-during-ramadan/ [Last accessed on 2014 Feb 18].
• 18 Zabeen B, Tayyeb S, Benarjee B, Baki A, Nahar J, Mohsin F. et al. Fasting during Ramadan in adolescents with diabetes. Indian J Endocr Metab 2014; 18: 44-47
• 19 Dawn Phenomenon Affects Half of Type 2 Diabetes Patients. Available from: http://www.medscape.com/viewarticle/814001 [Last accessed on 2014 Feb 13].
• 20 Monnier L, Colette C, Dunseath GJ, Owens DR. The loss of postprandial glycemic control precedes stepwise deterioration of fasting with worsening diabetes. Diabetes Care 2007; 30: 263-269
• 21 Monnier L, Colette C, Dejager S, Owens D. Magnitude of the dawn phenomenon and its impact on the overall glucose exposure in type 2 diabetes: Is this of concern?. Diabetes Care 2013; 36: 4057-4062
• 22 Stahl M, Berger W. Higher incidence of severe hypoglycaemia leading to hospital admission in Type 2 diabetic patients treated with long-acting versus short-acting sulphonylureas. Diabet Med 1999; 16: 586-590
• 23 Tessier D, Dawson K, Tétrault JP, Bravo G, Meneilly GS. Glibenclamide vs gliclazide in type 2 diabetes of the elderly. Diabet Med 1994; 11: 974-980
• 24 Kristensen JS, Frandsen KB, Bayer T, Muller P. Compared with repaglinide, sulfonylurea treatment in type 2 diabetes is associated with a 2.5-fold increase in symptomatic hypoglycemia with blood glucose levels - 45 mg/dl (Abstract). Diabetes 2000; 49 (Suppl. 01) A131
• 25 Goudswaard AN, Furlong NJ, Rutten GE, Stolk RP, Valk GD. Insulin monotherapy versus combinations of insulin with oral hypoglycaemic agents in patients with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2004: CD003418
• 26 Zammitt NN, Frier BM. Hypoglycemia in type 2 diabetes: Pathophysiology, frequency, and effects of different treatment modalities. Diabetes Care 2005; 28: 2948-2961
• 27 Al Suwaidi J, Bener A, Hajar HA, Numan MT. Does hospitalization for congestive heart failure occur more frequently in Ramadan: A population-based study (1991-2001). Int J Cardiol 2004; 96: 217-221
• 28 Bogdan A, Bouchareb B, Touitou Y. Ramadan fasting alters endocrine and neuroendocrine circadian patterns. Meal-time as a synchronizer in humans?. Life Sci 2001; 68: 1607-1615
• 29 el Ati J, Beji C, Danguir J. Increased fat oxidation during Ramadan fasting in healthy women: An adaptative mechanism for body-weight maintenance. Am J Clin Nutr 1995; 62: 302-307