COVID-19, Diabetes and Ramadan
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COMMENTARY
COVID-19, Diabetes and Ramadan Tahseen A. Chowdhury . Salman Waqar . Sufyan Hussain . Syed H. Ahmed . Ateeq Syed . Ali Karamat . Ahmed Helmy . Nazim Ghouri
Received: June 11, 2020 Ó The Author(s) 2020
Keywords: COVID-19; Ramadan
Fasting;
Diabetes;
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a newly emerged disease that has become a global public health emergency and has led to the implementation of extraordinary public health measures throughout the world in a short space of time [1]. At the time of writing, over a quarter of a million deaths have been reported worldwide
Tahseen A. Chowdhury and Nazim Ghouri are joint senior authors.
Digital Features To view digital features for this article go to: https://doi.org/10.6084/m9.figshare.12746837. T. A. Chowdhury Department of Diabetes and Metabolism, Royal London Hospital, London, UK S. Waqar Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK S. Hussain Department of Diabetes and Endocrinology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK S. H. Ahmed Department of Endocrinology and Metabolic Medicine, Countess of Chester Hospital NHS Foundation Trust, Chester, UK
[2]. Diabetes is a more slowly evolving pandemic, causing 4.2 million deaths worldwide in 2019 [3]. It is estimated that there are currently around 425 million people living with the condition, and a further 352 million with high risk of diabetes from impaired glucose regulation [3]. Type 2 diabetes mellitus (T2DM) affects many Muslims across the world, and a significant number of Muslims with diabetes seek to fast during the month of Ramadan [4]. The fast requires, for those adult Muslims without religiously acknowledged mitigating circumstances (e.g. significant acute or chronic illness and old age), the abstinence from food and water from dawn to dusk, which in the UK, depending on geographical location, is currently between 16 and 19 hours in duration [5]. People with diabetes need to take special care during Ramadan A. Syed A. Karamat A. Helmy Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK N. Ghouri (&) Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK e-mail: [email protected] N. Ghouri Department of Diabetes and Endocrinology, Elizabeth University Hospital, Glasgow, Queen, UK
Diabetes Ther
as they risk dehydration, hypo- or hyperglycaemia and, if severe, potential physiological decompensation [6]. There are a number of evidence-based and very recent independent, national and international guidelines on the management of diabetes during Ramadan [7–9]. The present COVID-19 epidemic represents an additional concern for Muslim people with diabetes wishing to fast. Muslims with any form of diabetes mellitus (DM), particularly T2DM, may be at significant risk of adverse outcomes of COVID-19 for three reasons. Firstly, it is now clear that the presence of T2DM and
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