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CASE-STUDY: diabetes and Ramadan

Mar 30, 2020

Many of the Muslim people living with diabetes across the globe decide to fast during Ramadan, having a strong faith and sense of community. Hence, it is very important to ensure them with optimal care and complete safety, both before, during and after Ramadan.

While we already discussed the role of peer support previously, medical consultations with informed healthcare professionals and endocrinologists remain at the frontline.


CASE-STUDY for safe fasting during Ramadan:

A 58-year-old man attends your clinic two weeks before Ramadan. He is a civil engineer and has been living with type 2 diabetes for the last 11 years.

He’s currently on Metformin 1.5gm/d, Gliclazide MR 120 mg/d, Siatagliptin 100mg/d and he started insulin intake Glargine, six months ago. He’s now on 24 units HS.

His current HbA1c is 7.3% (56mmol/l). He usually checks home blood glucose 2-3 times a week before breakfast. His blood glucose levels usually range from 90-130 mg/dl. His renal function is normal, BP is 130/80 and BMI is 28 kg/m2 . He has mild peripheral neuropathy and no CVD diseases.

During the last Ramadan he fasted without any problems. He’s keen on fasting this year again, but he is concerned about hypoglycaemia, as he’s now on insulin and he occasionally gets hypoglycaemia on busy days.

He lives with his wife and his 2 daughters.


In this discussion, members are asked to consider:

  1. What is the man's current risk for fasting?
  2. How can you minimize that risk, if he fasts during Ramadan?
  3. What other pieces of advise or considerations would you provide for his case?
Additional information:

Information about the discussion leader

Dr Mohamed Hassanein graduated from the Faculty of Medicine, in Alexandria, Egypt. He is a senior consultant in Endocrinology and Diabetes at Dubai Hospital, Dubai, UAE since 2014. He holds an Academic post of Senior Lecturer and Associate Director for Postgraduate Diabetes Education, at Cardiff University, UK since 2007. He was also appointed to the post of Consultant in the Department of Endocrinology and Diabetes at BCUHB, UK, in 2002.

His main research interest is in the field of diabetes and Ramadan. He is the Chair of the Diabetes and Ramadan International Alliance and co-authored many studies and recommendation papers on this subject for the American Diabetes Association (ADA) in 2005 and 2010, for the British Medical Journal in 2010, as well as the IDF-DAR practical guidelines, 2016. He has published over 70 papers and has presented more than 50 oral presentations at national and international meetings.