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Advice on Diabetes in Ramadan
INTRODUCTION

Islam is the second largest religion in Britain, after Christianity. In 2001, the number of Muslims in Britain was round 2.5 million. Devoted healthy Muslims commemorate the revelation of the Holy Quran by Allah to the Prophet Mohammed by fasting in the month of Ramadan every year. Ramadan lasts for 29 or 30 days, depending on the sighting of the moon. While continuing their daily occupation without time off, fasting Muslims abstain from food, liquids, tobacco, sexual activity and medication (oral, inhaler or injection) from sunrise to sunset. However, the sick, the pregnant and nursing mothers and children are exempt; moreover, if a fasting person becomes ill, he or she is allowed to end the fast in the day.
Feasting & Fasting

Ramadan directly influences the control of diabetes because of the month-long changes in meal times, types of foods, use of medication and daily lifestyle. Doctors and nurses who encounter Muslim diabetic patients need to understand the practicalities. What does a controlled diabetic Muslim do in Ramadan that a health professional should know about?

CUSTOMS IN RAMADAN

The religious goal of enhancing physical, psychological, social and spiritual wellbeing is achieved by the following daily customs.

Physical activities

In Ramadan a Muslim fasts from dawn to dusk and ends the fast with dates (or prunes if dates are not available) and water or juice.

Iftari, a big evening meal with extra sweet and savoury foods, but still a balanced diet, is taken after the sunset prayer.

Men walk to the local mosque for night prayer whilst most women pray at home (for reasons of safety).

Sehri, a light meal is taken before sunrise. Some Muslims omit this meal so as not to disturb their non-Muslim neighbours. This may contribute to hypoglycaemia during the day.

Healthy lifestyle, fasting and diabetes

Psychological activities

Prayer and meditation—which are akin to group therapy—result in self-audit and relaxation.

Religious leaders, elders and colleagues of the same sex provide counselling.

Social activities

Friends and relatives are invited to iftari, making it a feast and social event. Sick friends and relatives are visited, with sharing of the care as appropriate.

Spiritual activities

Taraveeh is a special night prayer: standing in the mosque the Muslim listens to the Holy Quran. A hafiz (who has the Holy Quran by heart) recites all 30 chapters of the Holy Quran through the month.

There is extra listening to sermons, and the Muslim becomes more pious and sensitive; he or she feels more guilty if a religious taboo is broken, even by medication. This guilt may be accompanied by self-disgust and spiritual pain—very unpleasant.

Self Care Guide for People with Type 2 Diabetes