Effect of Instructional Guidelines on Short Term Outcomes for Adolescents with Diabetes Mellitus during Fasting Ramadan

Abstract

Ramadan is the ninth month of the Islamic calendar, when Muslims fast during daylight hours. It is based on a lunar calendar; therefore, the duration of daily fast and the overall period of the month of Ramadan vary each year depending on the geographical location and season. Two main meals are usually consumed during Ramadan, before sunrise, known in Arabic as ‘Sohur’, and after sunset, known as ‘Iftar (Al-Agha et al., 2017). Short term clinical outcomes associated with Ramadan fasting for adolescent with uncontrolled diabetes include hypoglycemia, hyperglycemia with or without the risk of impending ketosis, dehydration, and thrombosis. There have not been any published reports of increased hospitalizations due to thrombotic cardiac or cerebral conditions in fasting persons whose diabetes is reasonably well controlled (Beshyah et al., 2017). Management of diabetes during Ramadan fasting is more complicated than many other conditions. It involves a careful balance between lifestyle and medications rather than just changing the times of a given medication. The situation is getting more complicated with the increasing number of anti diabetic drugs with different hypoglycemic potential. Management of diabetes during Ramadan fasting has featured recently in many monographs, guidelines, and medical journals articles (Morris, 2020).