Review of diabetes management and guidelines during Ramadan

Demographics of the Muslim population Islam is the second largest religion in the world and Muslims constitute approximately 22% of the world's population. According to latest data, the total number of Muslims in the world is over 1.5 billion. In Europe Muslims constitute approximately 7% of the overall population. In the UK the size of the Muslim population is estimated to be close to 1.6 million, constituting 2.7% of the overall population.1 While diabetes affects 4% of the white Caucasian population, it affects 22% of Pakistani and 27% of the Bangladeshi Muslim population (aged 25–74 years).2 The approximate number of Muslims in the UK with diabetes is estimated at 325,000.3 Most patients with diabetes are asymptomatic; they do not consider themselves as having an illness and fast during Ramadan. The concerns are fasting may lead to hypoglycaemia, hyperglycaemia with or without ketoacidosis, and dehydration. Another problem is the reluctance of patients in taking their medications during the fast, therefore timing and dosage of anti-diabetic agents has to be adjusted for individual patients. Despite all this, it must be pointed out that very few complications are actually seen in clinical practice.4 Managing Muslim patients with diabetes during Ramadan continues to be a challenge for healthcare professionals. This review is intended to offer a guide towards care of the Muslim patient with diabetes during Ramadan.