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About 325,000 Muslims in the UK have diabetes. While Islamic law exempts ‘sick’ people from fasting during Ramadan, most Muslims with diabetes do not feel ‘sick’ and choose to not eat, drink or take medication between sunrise and sunset, this despite concerns that fasting could undermine diabetes control.

Against this background, researchers interviewed 23 South Asian Muslims living in Greater Manchester. Thirteen fasted and altered their diabetes medication during Ramadan. The researchers found that “tensions” often “exist between the respondent’s personal desire to fast or not fast and their family’s opinion”. For example, some people reported guilt and embarrassment for not fasting. Some ate daytime meals in secret or when the family was out, while others fasted despite objections from their families. Several people reported feeling “more energetic and happier during Ramadan” despite fasting.

Respondents often altered their regimen to avoid hypoglycaemia but they generally did not want to disclose fasting to their GP or practice nurse “mainly because of the fear of being told not to fast”. Most respondents who had sought advice reported that the consultations with GPs or nurses were “unsatisfactory” with no help offered. Against this background, pharmacists and other health- care professionals could ask patients sympathetically if they intend to fast and offer information (e.g. on diet and medication) to ensure safe fasting. (Health Expectations)