A survey of patients with type 2 diabetes and fasting outcomes during Ramadan 2016 in London: The East London Diabetes in Ramadan Survey

Abstract

Aims: Fasting in the summer months for Muslim people with diabetes during Ramadan is challenging, particularly in temperate climates where the duration of fasting is prolonged. We aimed to survey the experiences of patients with diabetes during Ramadan 2016 in East London. Methods: A telephone survey of Muslim patients with type 2 diabetes in Tower Hamlets, London was carried out. Patients were surveyed on discussions with a health professional before Ramadan, whether they followed advice given, the number of fasts undertaken, alterations in medication and adverse events. Results: Of 1,000 people contacted, 718 agreed to the survey. 396 (55.1%) were female, the median age was 52.1 years (range 31-84) and median diabetes duration 13.6 years (range 1-45). 36 (5%) were treated with diet alone, 428 (59.6%) with oral antidiabetic therapy and 254 (35.4%) were treated with insulin. 372 people (52%) discussed fasting with a health professional; 126 (33.8%) were advised not to fast, of whom 103 (81.7%) elected not to fast. 398 (55.4%) fasted at least once; the median number of days fasted was 16 (range 1-30). 327 patients (82.1%) made changes to their therapy. 24 patients (6%) reported episodes of hypoglycaemia, of whom two (0.3%) required third party assistance. Conclusions: Significant numbers of patients did not discuss fasting with a health professional prior to Ramadan and some patients fasted despite medical advice. Despite the long duration, many patients fasted successfully for at least part of Ramadan, with few adverse outcomes.