Welcome to Journal Of Pakistan Medical Association

 Supplement Vol:65, No:5 May, 2015

Editorial >>

Diabetes care in Ramadan: An exemplar of person centered care

Fatema Jawad, Sanjay Kalra,

The World Health Organization defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.1 Ramadan, the holy month of fasting, is observed by about one-third of mankind every year. During this month, the d....

Ramadan Fasting in people with Diabetes

Abul Kalam Azad Khan,

Fasting is an essential component to many of the world's religions including Christianity, Hinduism, Islam, Jainism, Judaism and Baha'is. Fasting during Ramadan is one of the five pillars of Islam and obligatory for all healthy adult Muslims. According to 2009 demographic study, there are aroun....

Ramadan and Diabetes Mellitus

Zafar Ahmed Latif,

Physicians working in Muslim countries and communities commonly face the difficult task of advising people with diabetes on the safety of fasting as well as recommending the dietary and drug regimens to be followed during Ramadan. The lack of adequate literature on this subject makes it all the m....

Introduction >>

Physiological changes during fasting in Ramadan

Sultan Ayoub Meo, Asim Hassan,

Fasting during Ramadan is one of the five fundamental pillars of Islam and mandatory for all healthy adult Muslims to fast from sunrise to sunset for a period of a month. During fasting, Muslims are required to refrain from all intakes of food, water, beverages, smoking and from sexual intercours....

Basic rules of Ramadan: A medico-religious perspective

Bashir Ahmad Laway, Hamid Ashraf,

Fasting during the month of Ramadan is obligatory for all adult Muslims with few exceptions. The person observing a fast does not eat, drink, and smoke from dawn to dusk. Google and Medline search was undertaken for the articles related to basic rules of fasting-religious and medical perspectives....

Risk stratification of Ramadan fasting in person with diabetes

Monira AlArouj,

The world population comprises of 23% Muslims. Ramadan is the holy month of the Islamic year during which all healthy Muslims observe fasts. Although children and sick people are exempted from fasting but many of this group, want to observe fasts despite the medical advice against it. This includ....

Ramadan fasting in diabetic patients: When is fasting not advisable in a person with diabetes?

Adel Abdel Aziz El-Sayed, Eman Ahmad Sabet,

Ramadan Fasting is one of the five pillars of Islam, but there is a clear exemption in holy Qur'an for those who are temporarily or permanently ill. Diabetes Mellitus is one of the most prevalent chronic illnesses globally; it is associated with metabolic risks that might be augmented with fasti....

Should Type 1 diabetics fast in Ramadan

Fauzia Mohsin, Kishwar Azad, Bedowra Zabeen, Samin Tayyeb, Abdul Baki, Nazmun Nahar,

Fasting during the holy month of Ramadan is obligatory for all healthy adult and adolescent Muslims from the age of 12 years. This involves abstaining from eating or drinking from early dawn (Suhur/Sehri) till sunset (Iftar).Fasting is not meant to create excessive hardships or impart any adverse....

Pregnancy and fasting in women with diabetes mellitus

Faruque Pathan,

Fasting during the Holy month of Ramadan is one of the obligatory prayer for all normal healthy Muslims. There are a few special situations as pregnant and breastfeeding women, who are exempted from fasting. Different surveys observed that 70-90% pregnant women prefer not to accept this fiqh. A c....

Diabetes mellitus and Ramadan in elderly patients

Said Azzoug, Souad Mahgoun, Farida Chentli,

Worldwide, the proportion of people above 60 years old represents 15% of the whole population. Diabetes mellitus is more frequent in this age group, and is associated with increased risk of morbidities and premature mortality. Aged Muslim people with diabetes insist on fasting during Ramadan, for....

Pharmacological Management >>

Oral anti-diabetics in Ramadan

Najmul Islam,

A large proportion of Muslim patients with type 2 diabetes fast during the month of Ramadan worldwide. Hypoglycaemia is one of the major complications associated with long periods without food during the fasting hours. There is also a risk of hyperglycaemia due to over indulgence in food during t....

Newer antidiabetic drugs in Ramadan

Sarita Bajaj,

The management of diabetes in the month of Ramadan can be very challenging. On one hand there is the issue of fasting associated hypoglycaemia, and on the other, fasting as well as post prandial hyperglycaemia. Under such circumstances, a planned regimen needs to be followed to keep the blood glu....

Insulin in Ramadan

Sanjay Kalra, Fatema Jawad,

Many people with diabetes, both type 1 and type 2, require insulin for maintainance of glycaemic control and health. Most of these people can observe the Ramadan fast, provided appropriate dosage adjustments are made, and basic rules of safety followed. This article describes modifications and pr....

Fasting in Ramadan with an insulin pump

Jothydev Kesavadev,

A good majority of subjects with diabetes on insulin therapies observe fasting during Ramadan. The challenge for the physician and the patient is to manage diabetes without an interruption to fasting by avoiding hypoglycaemia and simultaneously ensuring thatá blood glucose remain at acceptab....

Glucose monitoring during Ramadan

Abdul Jabbar,

In patients with diabetes who intend to fast during Ramadan, self-monitoring of blood glucose (SMBG) is an important tool. During this month, a long established treatment regimen, including medications, physical activity and diet plan, is changed to achieve concordance with the rules of fasting. ....

Management of Co-Morbidities >>

Weight management in Ramadan

Bipin Kumar Sethi, V. Sri Nagesh,

Ramadan fasting is associated with significant weight loss in both men and women. Reduction in blood pressure, lipids, blood glucose, body mass index and waist and hip circumference may also occur. However, benefits accrued during this month often reverse within a few weeks of cessation of fastin....

Lipid Management in Ramadan

Ines Slim, Koussay Ach, Larbi Cha´eb,

During Ramadan fast, Muslims must refrain from smoking, eating, drinking, having sexual activity, and consuming oral medications from sunrise to sunset. It has been previously shown that Ramadan fasting induces favourable changes on metabolic parameters, reduces oxidative stress and inflammation ....

Coronary artery disease and diabetes - Management during Ramadan

Idris Ahmed Khan,

Ramadan is the Islamic holy month of fasting and practiced by all adult Muslims all over the world at the same time simultaneously. Although people who are ill or diabetics with coronary heart disease are exempted from fasting, they still desire to fast and this is a challenge to themselves and t....

How to avoid infections in Ramadan, especially urinary tract infections

Naseem Salahuddin,

Prolonged and poor control of diabetes has detrimental effects on the immune system by reducing both B and T cell function, causing neutrophilic dysfunction and less production of inflammatory cytokines. This makes people with diabetes vulnerable to various bacterial, viral and fungal infections ....

Gastrointestinal health in Ramadan with special reference to diabetes

Zaigham Abbas,

Fasting in the month of Ramadan can improve a person's health, but if the correct diet is not followed, one is prone to acquire some ailments related to the digestive health. Dyspeptic symptoms are frequently encountered during Ramadan, withá indigestion, bloating and heartburns being more ....

Non-Pharmacological Management >>

Diabetes and diet in Ramadan

Kehkeshan Hossain, Tabassum Zehra,

Ramadan, the month of fasting, is observed by Muslims all over the world. Fasting is obligatory for all healthy adult Muslims which amounts to refraining from eating and drinking from predawn to sunset. The dietary patterns therefore totally change. For people with diabetes, instead of taking 5-6....

Ramadan focused diabetes education; a much needed approach

Mohamed Hassanein,

Ramadan Fasting is passionately practiced by millions of Muslims with diabetes across the globe. Structured education is recommended by the various diabetes societies to empower the person with diabetes to better self manage their condition. Indeed, Ramadan focused diabetes education has been sho....

Ramadan and diabetes management - The 5 R's

Fatema Jawad, Sanjay Kalra,

The holy month of Ramadan is an opportunity for purifying the body and the soul. It brings a spiritual and physical well-being through the daily fasts and prayers. This applies to all persons observing the ritual of fasting. Although people with ill-health are exempted from fasting, but most of t....

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