Medical Illness, Diabetes and Fasting in Ramadan: Space for the Sacred in the Context of Sickness
Luma Ghalib, MD, Ohio State University; Muhamad Khalid, MD Resident, University of Pittsburgh Medical Center
In the secular domain of contemporary medicine, is there space for the sacred practice of fasting? How do medical recommendations about fasting change in the context of underlying illness? Ramadan is one of the holiest months in Islam and capable Muslim adults are obligated to fast during this month, abstaining from all food and drink from sunrise to sunset each day. Every year healthcare providers and religious leaders across the world are asked by patients if it is safe for them to fast during Ramadan. This question can pose particular challenges if the person has an illness such as diabetes, kidney disease or heart disease.
Medical and religious advisors, concerned about lack of nutrition and hydration and not wanting to jeopardize the person’s health, often advise against fasting. But studies have shown that many Muslim patients with both type 1 and type 2 diabetes still fast anyway, not willing to forgo the tremendous spiritual benefits of this devotional practice. They may not admit to their physician that they will be fasting for fear of admonition, and thus, they may fast without medical support or oversight. With 1.9 billion adherent Muslims around the world making up about one quarter of the world’s population, these questions and practices have global significance.
Having the knowledge and practical tools to meet the medical and spiritual needs of this population can be helpful to healthcare providers and religious advisors. Organizations have come together to develop and recommend evidence-based guidelines for fasting in the context of medical illness. The American Diabetes Association (ADA) published its guidelines on this issue in 2010. The International Diabetes Federation (IDF) is a global diabetes initiative of over 230 national diabetes associations in 170 countries that has been working with the Diabetes and Ramadan International Alliance (DaR) on this issue. They published their revised guidelines in 2021.
The purpose of this presentation is to educate attendees regarding recommended approaches to the medical management of patients with underlying illness, particularly diabetes, who wish to fast in Ramadan. It will cover risk stratification, early warning signs of complications, and medication adjustments. The presenter is a Muslim endocrinologist from an academic medical center who was selected to present the global DaR-IDF guidelines in a 2021 webinar for health care providers in North America. The presenter will discuss the challenges and risks these patients face and how medical and religious advisors can work together to help patients to benefit from the spiritual practice of fasting in Ramadan while protecting their overall health.
Medical and religious advisors, concerned about lack of nutrition and hydration and not wanting to jeopardize the person’s health, often advise against fasting. But studies have shown that many Muslim patients with both type 1 and type 2 diabetes still fast anyway, not willing to forgo the tremendous spiritual benefits of this devotional practice. They may not admit to their physician that they will be fasting for fear of admonition, and thus, they may fast without medical support or oversight. With 1.9 billion adherent Muslims around the world making up about one quarter of the world’s population, these questions and practices have global significance.
Having the knowledge and practical tools to meet the medical and spiritual needs of this population can be helpful to healthcare providers and religious advisors. Organizations have come together to develop and recommend evidence-based guidelines for fasting in the context of medical illness. The American Diabetes Association (ADA) published its guidelines on this issue in 2010. The International Diabetes Federation (IDF) is a global diabetes initiative of over 230 national diabetes associations in 170 countries that has been working with the Diabetes and Ramadan International Alliance (DaR) on this issue. They published their revised guidelines in 2021.
The purpose of this presentation is to educate attendees regarding recommended approaches to the medical management of patients with underlying illness, particularly diabetes, who wish to fast in Ramadan. It will cover risk stratification, early warning signs of complications, and medication adjustments. The presenter is a Muslim endocrinologist from an academic medical center who was selected to present the global DaR-IDF guidelines in a 2021 webinar for health care providers in North America. The presenter will discuss the challenges and risks these patients face and how medical and religious advisors can work together to help patients to benefit from the spiritual practice of fasting in Ramadan while protecting their overall health.