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Muslims with diabetes need better fasting support

Health professionals need better training on how to help Muslims with diabetes to fast safely during Ramadan, a study has suggested. 

Fasting with diabetes can have potentially serious health consequences, ranging from poor diabetes control and dehydration or a reduced quality of life and an increase in mortality. 

Researchers from the University of Manchester found tensions in British Muslims between observing the important religious ritual and the need to manage their health. 

There are three million people in the UK with diabetes, and a further 850,000 have undiagnosed type 2 diabetes. It is six times more common in the South Asian population and four times more common in the Bangladeshi and Pakistani groups than the general UK population. 

Around 325,000 Muslims have diabetes in the UK. But some avoided telling their GP or practice nurse they were fasting. Those who did were told not to fast, but ignored instructions feeling they could control their diabetes, or that the advice did not take into account the significance of fasting during Ramadan. 

The reluctance to disclose fasting was not influenced by the ethnicity of the GP. Regardless of whether the GP was Pakistani Muslim or white British some respondents still perceived their GP to have a lack of expertise to support them effectively during fasting.

Lead author Dr Neesha Patel, said: “Although the Islamic law states that the 'sick' can be exempt from fasting for one or all 30 days, the majority of Muslim respondents with diabetes do not perceive themselves as 'sick' and therefore choose to fast.

“Non-adherence to daily diabetes regime may result in more Muslim patients suffering the risks and complications associated with diabetes, leading to poor quality of life and increased use of NHS health services."

Professor Carolyn Chew-Graham, a Manchester GP and Professor of General Practice Research at Keele University who worked with Dr Patel on the study, added: “Our study shows the importance of considering patient experiences, especially when forming guidelines in this area and suggests a need for better training for GPs and practice nurses and with Mosques and community leaders.

“GPs and practice nurses need to ask patients if they intend to fast, and if they need information about how to fast safely. Health care professionals may also benefit from training and skills into providing culturally sensitive care, and patients also need to feel that they can discuss fasting openly in the primary care consultation.”

Jenne Patel, Diabetes UK Equality and Diversity Manager, said: “It is concerning that this research suggests that some Muslims feel uncomfortable in talking about their fasting decisions with their doctor or practice nurse and we need to send out the message that everyone with diabetes who is considering fasting throughout Ramadan should speak to their doctor, practice nurse and their Imam, who can help people come to the decision that is right for them.”

The research is available to view on the Health Expectations Journal website