Ramadan fasting and diabetes

Objective (s): The effect of Ramadan fasting on diabetes control is not clear yet. Some lifestyle changes like changes in drug dose and time, sleep wake cycle, physical activity and diet occur in Ramadan and can lead to metabolic imbalances. As such some studies have shown increased risk of hyperglycemia and hypoglycemia. So, it is necessary to make decision based on scientific evidences about safety and allowing fasting in a wide variety of patients on different stages of metabolic control. Moreover, appropriate changes in drug prescription should be recognized and used. In this review the results of various studies regarding the effects of Ramadan fasting on metabolic control of type 1 and 2 diabetes mellitus have been summarized and provided. Keywords including "Ramadan", "Ramadan Fasting", "Islamic Fasting", Fasting in Ramadan ", Calorie Restriction, Fasting and Starvation with words Diabetes Mellitus, Hyperglycemia, Hypoglycemia, Ketoacidosis, Glucose were searched via PubMed, SID (Scientific Information Database), and some regional journals and all articles (descriptive cross - sectional, cohort, clinical trial and review articles) from 1957 to 2010. The relevant articles were reviewed. In all 86 papers were included in this review. In diabetic patients safety of Ramadan fasting is defined as blood glucose in normal range. In type 2 diabetics with no chronic complication and able to self care, with proper training, planning the time and dose of drug, controlling of diet and physical activity and regular monitoring of blood glucose, fasting is allowed. In type 1 diabetics or insulin users, fasting should be allowed with caution, because, they are more at risk of hypoglycemia. Diabetic patients who wish to fast in Ramadan need to care about time, type and dose of their medications