Management of Diabetes in Individuals with Diabetes who are Fasting During Ramadan

Abstract

Fasting, which is important in many ancient religions, is also one of the basic conditions of Islam. During the month of Ramadan, Muslims do not eat and drink from dawn to sunset. The month of Ramadan continues for 29-30 days and the fasting period ranges from 10 to 20 hours depending on geographic location. The condition for fasting is to be healthy and not have chronic illness. However, with the thought that it is a religious obligation and will provide spiritual benefit, most individuals with chronic diseases also want to fast. Diabetes mellitus (DM) is considered a high risk condition for fasting in Ramadan, as it is a chronic metabolic disease and carries risks such as hypoglycemia and hyperglycemia during fasting. Hypoglycemia is a common problem during fasting during Ramadan. However, in clinical practice, most individuals with DM prefer to fast. Therefore, healthcare professionals must provide training to protect individuals with DM against various risks and to prevent hypoglycemic and hyperglycemic events. This review has been prepared in order for health professionals to make recommendations such as dose adjustment, risk classification, education, pharmacotherapy and blood glucose monitoring, medication and in line with the recommendations of the guidelines for type 1 and type 2 DM adults who plan to fast during Ramadan.

Keywords

• Diabetes mellitus
• glycemic control
• blood glucose monitoring
• oral antidiabetic medicine
• insulin therapy

Ramazan Ayında Oruç Tutan Diyabetli Bireylerde Diyabetin Yönetimi

Abstract

Diabetes mellitus (DM) kronik metabolik bir hastalık olduğu ve oruç sırasında hipoglisemi, hiperglisemi, dehidratasyon ve koagulasyon gibi riskler taşıdığından Ramazan orucu için riskli bir durum olarak kabul edilir. Ramazan ayı boyunca Müslümanlar, şafaktan gün batımına kadar geçen süre boyunca yiyecekten, içecekten, sigaradan ve cinsel ilişkiden uzak dururlar. Ramazan ayı 29-30 gün sürmekte ve oruç tutulan süre coğrafi konuma göre 10 ila 20 saate kadar uzun bir zaman dilimini kapsamaktadır. Oruç tutmak için şart, sağlıklı olmak ve kronik hastalığa sahip olmamaktır. Ancak, dini zorunluluk olduğu ve manevi fayda sağlayacağı düşüncesiyle kronik hastalığı olan çoğu birey de oruç tutmayı istemektedir. Ramazan ayında oruç sırasında hipoglisemi korkusu da yaygın bir sorundur. Bununla birlikte, klinik uygulamada DM’li bireylerin çoğu oruç tutmayı tercih etmektedir. Bu nedenle sağlık uzmanlarının çeşitli risklere karşı DM’li bireyleri koruması, hipoglisemik ve hiperglisemik olayları önlemek için bu özel durumlara özgü eğitim vermesi zorunluluğu kaçınılmazdır. Bu derleme, sağlık uzmanlarının Ramazan ayında oruç tutmayı planlayan tip 1 ve tip 2 DM’li yetişkin bireylere kılavuzların önerileri doğrultusunda risk sınıflandırması, eğitim, farmakoterapi ve kan şekeri takibi, ilaç ve doz ayarlaması gibi önerilerde bulunabilmek için hazırlanmıştır.

Keywords

• Diabetes mellitus
• glisemik kontrol
• kan şekeri takibi
• oral antidiyabetik ajan
• insülin tedavisi

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