Clinical Pearl: Ramadan - Reminder to Health Care Practitioners

*Ramadan in 2012 will start on Friday, the 20th of July and will continue for 30 days until Saturday, the 18th of August.

The fourth requirement of Islam is fasting during Ramadan: the 9th month of Islamo-Arabic lunar calendar. Ramadan is considered a month of community because religious practices such as prayers, fasting, charity, and self-accountability are often practiced within community setting. During fasting, Muslims avoid eating, drinking and smoking from sunrise to sunset. Muslims gather as family and community in the evenings to open their fast by prayers and read the Qur'an in the evenings. Patients may receive an increasing number of visitors during this month.

Abstention from food and drink may bring problems for Muslim patients who wish to fast because, to most patients, Ramadan is believed to be the most blessed and spiritually-beneficial month of the Islamic year. Based on the Quran, those who are sick, elderly, or on a journey, and women who are pregnant or nursing are permitted to break the fast and make up an equal number of days later in the year: [2:185]

"The month of Ramadan is the one in which the Qur'an was revealed, as guidance for humanity, and demonstration in the way of guidance and discrimination. So whoever among you is present that month should fast. If anyone is ill or on a journey, then the prescribed term is to perform other days. God wishes ease for you, not hardship; and that you fulfill the prescribed terms, and that you celebrated God for guiding you, and to express your appreciation."

The diurnal pattern of caloric intake is obviously reversed and diabetic schedules will have to be adjusted to accommodate this significant change. Sometime in the month prior to Ramadan a discussion between provider and patient should take place to plan medication schedules for the month of Ramadan.