Mehmet Akif Buyukbese
Experimental and Applied Medical Science - 2025;6(4):372-383
There is an increasing trend of observing Ramadan for people with diabetes (DM) although they are exempt from fasting. DM itself is also a growing epidemic in muslim people especially in the Middle -East and North Africa (MENA) Region. Hypoglycaemia (hypo), significant hyperglycaemia (glucose level equal or over than 300 mg/dl) are the cut off numbers to break the fast according to the international authorities. Not only these two, but dehydration, thrombosis, diabetic ketoacidosis and hyperosmolar non -ketot ic coma are the fearful complications during the observance. Glycaemic control can be obtained with careful attention to the glucose readings throughout the day while taking into consideration of fasting and postprandial periods (after sahoor, and iftaar). Time in Range (TIR) as well as glucose variability are important factors, -lately emphasized for diabetes management other than Hba1c (A1c) - so as to get rid of later complications - macrovascular and microvascular ones - provoked by advanced glycation end -products (AGEP) and oxidative stress. Anxiety of everyday finger pricking for glucose measurement can be replaced with artificial intelligence (AI) used equipments for those who can afford. They are either part of continuous glucose monitoring systems (CGM S) or insulin pump delivery machines giving rise to less glucose spikes, less use of total insulin and smart warnings for hypo.
