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Ramadan fasting can create problems for endocrine patients

By Priscilla Lynch - 02nd Sep 2022

endocrine diseases

Ramadan fasting can create complications for patients with endocrine diseases, according to three new studies presented at the 24th European Congress of Endocrinology. 

The studies looked into the impact on patients with diabetes and hypothyroidism, and provided a general overview of the frequency of emergency endocrine issues during the month of Ramadan. 

High-risk of emergency hospital admission in fasting patients with diabetes 

During the holy month of Ramadan in 2021 (April 13 to May 12), Dr Lionel Simeu and his team from Morocco’s IBN Rochd University Teaching Hospital, observed that 150 diabetic patients were rushed to their emergency room with a serious metabolic issue. Diabetic ketosis was the primary reason for admission (57 per cent), while the frequency of hypoglycaemia remained low (2 per cent). 

“If fasting during Ramadan is allowed in healthy patients, it must be stopped if a patient’s diabetes is uncontrolled,” said Dr Simeu. “Therapeutic education and sufficient medical care are essential to avert acute issues.” 

Pre-fasting consultation is crucial to manage endocrine conditions 

Two studies from UHC IBN Rochd in Casablanca, Morocco, looked at endocrine emergencies during Ramadan in general and in thyroid patients specifically. 

Dr Amine Gueddari and his team examined 62 patients who were followed in consultation for hypothyroidism. The researchers wanted to see how fasting throughout Ramadan altered hormone balance and compared the use of L-thyroxine, used to treat an underactive thyroid, 30 minutes before the meal to break the fast at sunset (iftar) and at the pre-sunrise meal (suhoor). 

“Fasting during Ramadan may induce hormonal imbalance in patients with hypothyroidism”, said Dr Gueddari. “It is therefore critical to teach patients how to take their medicine and to follow-up with them after the month of fasting.” 

Dr Yousra Settai and her colleagues conducted a prospective study to determine the frequency of endocrine emergencies during Ramadan, and the risk of endocrine decompensation as a result of fasting. The study comprised 47 people who sought medical help for endocrine emergencies during Ramadan 2021. 

“Fasting during Ramadan is a spiritual rite for Muslims, but it comes with concerns since it can cause hormonal imbalances,” said Dr Settai. “We recommend a pre-Ramadan consultation in endocrine patients to adjust the treatment and discuss options”.

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