Researchers from Leicester, working in close collaboration with international diabetes experts, have produced updated guidelines for Muslim patients with type 2 diabetes during Ramadan. The guidelines are published in BMJ Open Diabetes Research and Care.
In the Holy Qur’an, illness constitutes an exemption from fasting during Ramadan. However many people with diabetes may still choose to fast.
To help people with type 2 diabetes stay healthy during this time, experts from the Leicester Diabetes Centre (LDC) have published new guidelines supported by the National Institute of Health Research (NIHR) Leicester Biomedical Research Centre (BRC) and NIHR Applied Research Collaboration (ARC) East Midlands.
The new guidance applies the principles of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consensus recommendations of 2018 and its update in 2019 to the management of people with type 2 diabetes during Ramadan including the use of SGLT2i and GLP1-RA, two medicines that improve glycaemic control.
This new paper highlights the need for a person-centred approach and puts the person with type 2 diabetes at the centre of the care.
Dr Ehtasham Ahmad from the LDC and one of the principal authors of the guidelines said, “Ramadan can be a challenging time for many people with type 2 diabetes who choose to fast. We believe these guidelines will help healthcare providers and people with type 2 diabetes feel able to navigate through this time safely and effectively.”
Professor Kamlesh Khunti, co-director of LDC said, “This guidance is even more important in current difficult circumstances with the COVID-19 pandemic and the Leicester Diabetes Centre wishes Ramadan Kareem to all in this holy month.”
Professor Melanie Davies, Director of the NIHR Leicester BRC, said, “It is important that we can support the health care providers and people with type 2 diabetes who fast manage the condition well during the Holy month and give them the right information in light of emerging evidence.”
The guidelines highlight the need for multiple avenues of support that can be provided by healthcare professionals. Access to pre-Ramadan counselling, risk categorisation and a personalised approach to ensure fears, concerns and meal planning are addressed, bearing in mind cultural and religious beliefs.
Muslims with type 2 diabetes are also encouraged to engage in education programmes that will further raise their confidence and knowledge around their condition and fasting. Programmes such as Safer Ramadan from Desmond are available for healthcare provider organisations: https://www.desmond-project.org.uk/portfolio/desmond-foundation/
For an alternate version of the figure see: ADA_Ramadan_V3_Figure_1
The full guideline Recommendations for Management of Diabetes during Ramadan: update 2020, applying the principles of the ADA/EASD Consensus is published in BMJ Open Diabetes Research and Care, on 4th May 202