Three Muslim women working during Ramadan, the fasting month.

Despite a large Muslim population throughout the world, the effect of fasting during Ramadan on diabetes patients remains relatively understudied.

The holy month of Ramadan means Muslims must go without eating or drinking from dawn to sunset, and then break the fast in the evening with Iftar.

Studying the Effects of Fasting for Muslims with Type 2 Diabetes

A group of researchers from Khoo Teck Puat Hospital’s (KTPH) Clinical Research Unit aimed to study the metabolic impact of Ramadan fasting on Type 2 diabetes patients in Singapore. Changes in dietary intake, body composition and metabolic profile of this group of patients were investigated.

A group of 29 Southeast Asian Muslim patients with Type 2 diabetes were recruited for the prospective cohort study conducted at KTPH’s Diabetes Centre.

Do’s and Don’ts During Ramadan Fasting

All patients received pre-Ramadan education from physicians on diabetes management during the fasting period. This included: 

  • frequent monitoring of blood glucose levels,
  • acute management of hyperglycaemia and hypoglycaemia, and
  • appropriate adjustments in dosage and timing of medications. Dietitians also provided nutritional advice on food and drinks, so that the patients could plan their pre-dawn and evening meals carefully.

During the fasting period, participants charted their blood glucose reading five times a day to guide their diabetes self-management.

At the end of Ramadan, the results showed that fasting conferred improvements to blood glucose levels. There was also a modest but significant reduction in body fat mass for diabetics, especially women. The study also allowed researchers to identify the various needs of diabetic patients during the Ramadan fasting period.

Results

The researchers concluded that appropriate patient education, blood glucose monitoring and adjustment of medication dose and timing can allow Muslim patients with Type 2 diabetes to fast safely during Ramadan.

Led by Dr Ester Yeoh, Consultant, General Medicine, this study was published in the Annals Academy of Medicine Singapore 2015 and won the Gold Best Paper Award in 2016.

Related: How to Manage Fasting with Diabetes

In Summary

young Muslim family getting ready to eat and drink as they begin breaking fast during Ramadan

Pre-Ramadan Education

  • monitoring of blood glucose levels
  • acute management of hyperglycaemia and hypoglycaemia
  • dosage and timing of medications
  • nutritional advice

Diabetes Self-Management During Ramadan

  • charting of blood glucose reading five times a day

Post-Ramadan Results

  • improvements to blood glucose levels
  • significant reduction in body fat mass
  • various needs of diabetic patients during Ramadan identified

Conclusion

With medical guidance, it is possible for Muslims with Type 2 diabetes to fast safely during Ramadan.

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