COVID-19 research briefs: Updated recommendations on diabetes management during Ramadan and pandemic

Reference

Hanif S, Ali SN, Hassanein M, Khunti K, Hanif W. Managing people with diabetes fasting for Ramadan during the COVID-19 pandemic: A South Asian Health Foundation update. Diabetic Med 2020;37(7):1094-1102.

Synopsis

Research brief #43: As an update to previous recommendations on management of diabetes during Ramadan, these authors urge that patients with type 1 diabetes not fast. Those choosing to do so should check their blood sugars at least 4 times each day, if not more often, and adjust insulin doses individually and very carefully. Fasting is only recommended for people with well-controlled type 2 diabetes (HbA1c < 7.5%; 59 - 69 mmol/mol) who use monotherapy and are otherwise healthy. All of the new classes of medications, including DPP-4 inhibitors, SGLT-2 inhibitors, and GLP-1 receptor agonists, are considered to carry a low risk of hypoglycemia; no reduction in dose is needed during fasting. Regardless of type of medication, patients are encouraged to avoid dehydration and not to fast if they have any symptoms of COVID-19 or recent exposure to individuals affected with COVID-19.