Introducing the Practical Guideline for Diabetes and Ramadan, Developed by International Diabetes Federation in Collaboration with Diabetes and Ramadan International Alliance, 2016

Document Type : Letter to the Editor


1 Biochemistry and Nutrition, Endoscopic and Minimally Invasive Surgery and Cancer Research Centers, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran


Considering the fact that many Muslims with diabetes prefer to fast in spite of inhibitory advises and to answer several conflicts and controversies regarding diabetes and Ramadan, IDF in collaboration with Diabetes and Ramadan (DAR) International in Alliance decided to develop a comprehensive guideline to be used by health care professionals. This guideline was then developed on April 2016 by 12 main authors and 20 co-authors from all around the world, and published by International Diabetes Federation. The guideline is provided in nine chapters: 1) Introduction to the IDF-DAR Practical Guidelines, 2) Epidemiology of Diabetes and Ramadan Fasting, 3) Physiology of Ramadan Fasting, 4) Risk Stratification of Individuals with Diabetes before Ramadan, 5) Diabetes and Ramadan: A Medico-religious Perspective, 6) Pre-Ramadan Education, 7) Ramadan Nutrition Plan (RNP) for Patients with Diabetes, 8) Management of Diabetes during Ramadan and 9) Identifying and Overcoming Barriers to Guideline Implementation. This guideline tries to answer three main questions: 1) Is fasting during Ramadan associated with a significant risk? 2) What are the criteria that predispose patients with diabetes to increased risk during fasting? 3) What is the most appropriate oral anti-diabetic drug(s) or type and regimen of insulin for patients with type 2 diabetes who fast? IDF-DAR Practical Guideline is now available at:


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  2. Salti I, Benard E, Detournay B, et al. A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries: results of the epidemiology of diabetes and Ramadan 1422/2001 (EPIDIAR) study. Diabetes Care 2004;27:2306-11.
  3. Ahmedani MY, Alvi SF, Haque MS, et al. Implementation of Ramadan-specific diabetes management recommendations: a multi-centered prospective study from Pakistan. J Diabetes Metab Disord 2014;13:37.
  4. International  Diabetes  Federation  and  the  DAR International  Alliance.  Diabetes  and  Ramadan: Practical Guidelines. Brussels, Belgium: International Diabetes  Federation,  2016.