Feasibility of Ramadan Fasting in Adults with Type 1 Diabetes: an Observational Study

Ramadan fasting is usually a challenge for both Muslim patients with diabetes and their health care providers. The challenge is even greater in patients with type 1 diabetes. Existing clinical guidelines categorize patients with type 1 diabetes as very-high-risk patients, and therefore, they are advised not to fast. However, many patients with type 1 diabetes choose to fast despite medical advice. In this study, we examine the feasibility of Ramadan fasting in adult patients with type 1 diabetes and define the frequency of acute complications in these patients during Ramadan. In this retrospective study, patients aged 18 years or older with type 1 diabetes who choose to fast during the month of Ramadan in the year 2015 were interviewed during their first visit after Ramadan, and their records were reviewed to determine the number of days in which patients broke the fast, frequency of hypoglycemia, hyperglycemia and diabetic ketoacidosis, and frequency of hospitalization during Ramadan. The 73 patients included in the study were able to fast an average of 26.8 days which corresponds to 92% of total fasting days. Hypoglycemia and hyperglycemia caused the patients to break the fast in 2.36 and 2.78% of the total fasting days, respectively.