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Patients who fast in Ramadan need better advice

BMJ 2012; 345 doi: (Published 12 July 2012) Cite this as: BMJ 2012;345:e4754
  1. Zohra Ismail Panju, general practice trainee
  1. 1Imperial NHS Trust, St Mary’s Hospital, London W2 1NY
  1. z.ismailpanju{at}

Ramadan is the lunar calendar month in which Muslims spiritually and physically “cleanse,” which includes abstaining from food and drink between dawn and dusk. This year Ramadan will be observed between 19 July and 18 August. Being Muslim, this was a tradition I grew up with, and aside from new diagnoses of diabetes presenting during this time, resulting from dehydration or blood glucose derangements exacerbated by fasting, I had never considered the medical implications.1 2

In my more youthful years, Ramadan fell in winter, and late sunrise and early sundown meant that you really only missed lunch. Islam prioritises health above all else so it always seemed clear that you fasted if you could, and if you couldn’t then you didn’t. It was only when I began a general practice rotation last year that I saw that the situation is often less clear cut, and religious fasting has the potential to adversely affect health.

The …

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