87th CME Event: Management of Type 2 Diabetic Mellitus during the Holy Month of Ramadan

Fasting in Ramadan is one of the five pillars of Islam. Therefore, muslim patients insist on fasting. 415 million people have diabetes in the world and almost 153 million people in the WP Region; by 2040 this will rise to 215 million. There were 3.4 million or 14.9% cases of diabetes in Malaysia in 2015. According to the CREED study, 94.2% of Muslims with T2DM who fast during Ramadan fast for at least fifteen days; many of these patients fast every day. Eating habit changes in many ways.
During the holy month of Ramadan there’s change in meal time, pattern of meal, calorie intake and there’s increased post-prandial physical activity during the night associated with Tarawih. Therefore, managing diabetic patients observe fasting is a challenge for the Clinicians.
Challenges for a Clinician during Ramadan for optimal control of T2DM include:
 Check eligibility of patient to observe fasting
 Managing risks associated with fasting
 Blood glucose monitoring while fasting
 Adjustment of diet, exercise & drugs
 Selecting the suitable oral anti-diabetic drug (OAD) in Ramadan
One study showed that T2DM patients without education experienced 4 times hypoglycaemia [Diabet. Med. 27, 327–331 (2010)]. So pre-Ramadan education is important to minimize risks. American Diabetic Association (ADA) working group report on recommendations for management of diabetes during in Ramadan.
At the end of the session the participants would be able to determine & evaluate the risk factors, complications & management of Type 2 diabetic Muslim population taking glucose lowering agents during the holy month of Ramadan.