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Practice 10-Minute Consultation

Ramadan fasting and diabetes

BMJ 2007; 335 doi: (Published 20 September 2007) Cite this as: BMJ 2007;335:613
  1. Aziz Sheikh, professor of primary care research and development1,
  2. Sunita Wallia, research dietician2
  1. 1Division of Community Health Sciences, GP Section, University of Edinburgh, Edinburgh EH8 9DX
  2. 2Division of Community Health Sciences: Public Health Sciences, University of Edinburgh, Edinburgh EH8 9AG
  1. Correspondence to: A Sheikh aziz.sheikh{at}
  • Accepted 17 August 2007

A 45 year old Pakistani man with type 2 diabetes mellitus consults to discuss how he might fast safely during Ramadan.

What issues you should cover

  • Explore his motivation—whether he wants to fast (as most will) or whether he is looking for a “legitimate” exemption from fasting on medical grounds. A diagnosis of diabetes does not confer an automatic exemption, so if the second scenario is suspected it needs to be explored with sensitivity.

  • Although everyone agrees on the need to avoid food and drink during daylight hours, a range of views exists on the use of drugs. Ask his opinion on the use of oral and injectable drugs when fasting.

  • Find out how long the fast will last. The length of the fast varies according to the time of year in which Ramadan falls. Ramadan starts on about 12 September this year and in the United Kingdom the fast will be about 13 hours at the start of the month and 11 hours at the end of the month. If Ramadan falls in the summer, fasts can last for more than 18 hours, in which case fasting for people with diabetes can prove …

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