Clinical Case Database / Category: Patient Management
Diabetes and ramadan
Publication details
Elaine Hui, Vassiliki Bravis, Margaret Devereux, Devasenan Devendra
Foundation Years Journal, volume 4, issue 9, p.26 (123Doc Education, London, December 2010)
Abstract
The following case highlights the potential risks of both hypoglycaemia and renal impairment in Muslim patients with type 2 diabetes who fast during the lunar month of Ramadan from sunrise to sunset. A 66-year-old Muslim man with type 2 diabetes treated with metformin and gliclazide, was fasting during the daylight hours of Ramadan. He was admitted with symptomatic hypoglycaemia and acute renal impairment following a short history of diarrhoea. A diagnosis of viral gastroenteritis and dehydration secondary to prolonged fasting was made. The hypoglycaemia was precipitated by a combination of fasting, gliclazide use and acute renal impairment. Although the choice of fasting rests with an individual, the risks could be minimised through patient education and medical assessment before Ramadan. It is also important for all healthcare professionals to be aware of and respect this religious obligation in order to provide appropriate care for patients with diabetes who choose to fast during Ramadan.
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Authors
Elaine Hui
Jeffrey Kelson Diabetes Centre
Central Middlesex Hospital
Acton Lane
Park Royal
London, NW10 7NS
Vassiliki Bravis
Jeffrey Kelson Diabetes Centre
Central Middlesex Hospital
Acton Lane
Park Royal
London, NW10 7NS
Margaret Devereux
Jeffrey Kelson Diabetes Centre
Central Middlesex Hospital
Acton Lane
Park Royal
London, NW10 7NS
Devasenan Devendra
Jeffrey Kelson Diabetes Centre
Central Middlesex Hospital
Acton Lane
Park Royal
London, NW10 7NS
d.devendra@imperial.ac.uk
References
1. Koran 2:183-185.
2. Salti I, Be´nard E, Detournay B et al. (2004) Results of the Epidemiology of Diabetes and Ramadan 1422 ℠2001 (EPIDIAR) study. Diabetes Care, 27: 2306–2311.
3. Al-Arouj M, Bouguerra R, Buse J, et al. (2005) Recommendations for management of diabetes during Ramadan. Diabetes Care, 28(9):2305–2311.
4. Glimperide in Ramadan (GLIRA) Study Group (2005) The efficacy and safety of glimepiride in the management of type 2 diabetes in Muslim patients during Ramadan. Diabetes Care, 28:421–422.
5. Mojaddidi M, Hassanein M, Malik R. (2006) Ramadan and diabetes: evidence-based guidelines. Prescriber, September;38–41.
6. Hassanein M, Bravis V, Hui E, Devendra D. (2009) Ramadan-focused education and awareness in type 2 diabetes. Diabetologia, 52(2):367–368.
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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