Fasting during the month of ramadan for people with diabetes: Medicine and fiqh united at last

Abstract

AbstractFasting during the lunar month of Ramadan is a religious obligation for all adult Moslems. Under certain circumstances, a few groups are exempt from fasting such as being “sick” as judged by an experienced doctor. Recent collaboration between the International Islamic Fiqh Academy and The Islamic Organization for Medical Sciences produced a comprehensive guidance based on extensive review of the evidence of possible risk to diabetic patients if they observe fasting. The new guidance categorized people with diabetes into 4 groups according to their risk. Group 1 and 2 are exempted from fasting as they have risk from fasting. These included patients with poor glycemic control or with complications and serious coexisting illnesses in addition to type 1 patients and pregnant women with diabetes. Patients in groups 3 and 4 are those with moderate to low risk of harm from fasting. These are exemplified by uncomplicated patients with stable control on oral drugs not associated with excess risk of hypoglycemia. These groups of patients have no harm but may even benefit from fasting. Doctors and religious scholars have a joint responsibility to properly assess and advise patients to choose to fast or not to fast in line with these recommendations. The advice should be Fasting during the lunar month of Ramadan is a religious obligation for all adult Moslems. Under certain circumstances, a few groups are exempt from fasting such as being “sick” as judged by an experienced doctor. Recent collaboration between the International Islamic Fiqh Academy and The Islamic Organization for Medical Sciences produced a comprehensive guidance based on extensive review of the evidence of possible risk to diabetic patients if they observe fasting. The new guidance categorized people with diabetes into 4 groups according to their risk. Group 1 and 2 are exempted from fasting as they have risk from fasting. These included patients with poor glycemic control or with complications and serious coexisting illnesses in addition to type 1 patients and pregnant women with diabetes. Patients in groups 3 and 4 are those with moderate to low risk of harm from fasting. These are exemplified by uncomplicated patients with stable control on oral drugs not associated with excess risk of hypoglycemia. These groups of patients have no harm but may even benefit from fasting. Doctors and religious scholars have a joint responsibility to properly assess and advise patients to choose to fast or not to fast in line with these recommendations. The advice should be given with no complacency with the potential health risks but with great sensitivity to the patients religious feelings.