New guidelines on diabetes and Ramadan
The International Diabetes Federation (IDF) has issued comprehensive guidelines to address diabetes and Ramadan, including religious as well as medical guidance. These guidelines are available on the IDF website and were developed and written by the Diabetes and Ramadan (DAR) International Alliance.Few recommendations are:
· Healthcare professionals must be conscious of the risks associated with fasting and should quantify and stratify the risks for every patient individually in order to provide the best possible care.
· The new risk categorizations as defined by the IDF and Diabetes and Ramadan International Alliance (IDF-DAR) are very high risk (Category 1), high risk (Category 2) and moderate/low risk (Category 3). Patients who are in the two highest categories of risk are advised not to fast; however, many of these patients will choose to do so and this must be respected.
· Older people should not be categorized as high risk based on a specific age but rather on health status and social circumstances.
· HCPs should be trained to deliver Ramadan-focused diabetes education in a culturally sensitive manner.
· Having the skills to self-monitor blood glucose levels can empower patients with diabetes to effectively self-manage their disease.
· Adjustments to the dose and/or timing of some medications may be required during Ramadan to minimize the risk of hypoglycemia in fasting patients.
· Meals should be balanced. The guidelines have devised a “Ramadan plate” method as a guide to designing meals
· All patients should break their fast if: Blood glucose <70 mg/dL, re-check within 1 h if blood glucose 70-90 mg/dL, Blood glucose >300 mg/dL and/or symptoms of hypoglycemia, hyperglycemia, dehydration or acute illness occur.