Abstract
AbstractFasting is one of the five pillars of Islam, and consequently, even the Muslims with diabetes prefer to fast fast during Ramadan, irrespective of the healthcare implications. However, this fast can be very difficult to manage in patients of Type 1 diabetes (T1DM), who are on insulin therapy. Risks of diabetic ketoacidosis, severe hypoglycaemia, hyperglycemia, dehydration and thrombotic episodes are increased. Lack of proper pre-fast assessment, management and diabetes education have been stumbling blocks in facilitating Ramadan fasting in type 1 diabetes patients. Recent developments like the use of insulin pumps and analogs and recognition of the importance of structured diabetes education and assessment to select the patients best suited for the rigors of fasting, have wrought a sea change in the usually negative approach of doctors towards Ramadan fasting in patients with T1DM. Sophisticated therapeutic options like smart insulins, can provide safer and more convenient options for management of Type 1 diabetes during Ramadan, a few years down the line. More studies are also needed to explore other options like GLP-1 agonists, alpha glycosides inhibitors and DDP-4 agonists, as adjuncts to insulin therapy.
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