Diabetes & Ramadan Position Statement Launched

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Program Aimed At Islamic Community & Managing Diabetes In Scientific Way When Fasting

MISSISSAUGA: The Stop Diabetes Foundation, in collaboration with Diabetes Canada, has launched the first ever Canadian Diabetes & Ramadan Position Statement (CDR) to educate healthcare providers as well as the public about the latest evidence on fasting with diabetes during Ramadan, keeping in mind the Canadian context.

The CDR was developed with the consensus of diabetes specialists, researchers as well as religious leaders. Going forward, it is envisioned to have this position statement endorsed by Diabetes Canada and submitted for publication in a Canadian medical journal before the start of Ramadan in the middle of May 2018.

The one-hour program at the Mississauga Convention Centre  was kicked-off by Mr. Manzur Bhinder, a 78 year old devout Muslim living with type 2 diabetes for over 34 years. He shared his life story of fasting every year during Ramadan and the potential challenges with diabetes during fasting. The Canadian expert faculty involved with this project: Dr. Harpreet Bajaj, Dr. Tyceer Abouhassan, Dr. Muhammad Ahsan, Dr. Tayyab Khan, Dr. Hasnain Khandwala and Dr. Subodh Verma then enlightened the audience about the highlights of the CDR position statement.

Peel Region holds the unfortunate distinction of being the “Diabetes capital of Canada”. STOP Diabetes foundation’s (SDF) mission termed ‘SDF VISION 2020’ aims to remove this infamous #1 tag before the year 2020. In addition to this mission of prevention, the foundation’s second goal is to support those living with diabetes live a long and complication-free life.

Type 2 diabetes is a growing epidemic, especially in certain immigrant populations in Canada including people with origins from South Asia and the Middle East. According to national statistics, the Muslim population in Canada is steadily growing.

Fasting from dawn to dusk during Ramadan comprises one of the five pillars of Islam and is observed by a majority of Muslims. Though certain individuals are exempted from fasting (e.g. pre-pubertal children and those who are ill, pregnant or breast feeding), many of those who fall under these categories often opt to still follow the practice.

Management of both types 1 and 2 diabetes during Ramadan is challenging for Canadian healthcare providers because of limited evidence around this topic.

While the International Diabetes Foundation Diabetes and Ramadan (IDF-DAR) guidelines serve as a useful basis of educating patients and healthcare providers regarding this, important differences based on the availability of medications, and the variability in the duration of the fast in Canada lead to a knowledge gap and are an unmet need for the Canadian healthcare providers to help their patients fast safely during Ramadan.

Some of the topics discussed included:

1. Pre-Ramadan assessment by healthcare professionals to gauge patients’ risk for fasting and provide guidance regarding diet and monitoring of glucose control.

2. Adjustment of both insulin and non-insulin treatments for those living with type 2 diabetes who intend to fast during Ramadan.

3. Titration of insulin treatments for those living with type 1 diabetes who intend to fast during Ramadan.

4. Monitoring of glucose control during Ramadan including debunking the myth that glucose testing invalidates the fast. .

5. Safety first: the overarching goal should be to support people who intend to fast do so safely, while minimizing the risks of low sugar reactions (hypoglycemia) or dehydration. If any of these occur, the fast should be broken and medical advice sought immediately.

Messages of support for this important health initiative came from Diabetes Canada scientific leaders Mrs. Jovita Sundaramoorthy and Dr. Peter Senior, several religious leaders, Dr. Hisham Mahmoud (Sanofi Canada) and Dr. Mohamed Hassanein (chair of the International Diabetes Federation’s Diabetes and Ramadan alliance based in Dubai).

The Canadian Diabetes & Ramadan position statement will be widely distributed to healthcare providers across the country in collaboration with Diabetes Canada. The plan is to make this document freely available on www.stopdiabetesfoundation.com and on social media platforms.