Diabetes & Primary Care’s series of interactive case studies is aimed at all healthcare professionals in primary and community care who would like to broaden their understanding of type 2 diabetes.
The two mini-case studies created for this issue of the journal cover various aspects relating to the safe management of type 2 diabetes during the Islamic month of Ramadan, when many Muslims observe fasting during daylight hours.
The format uses typical clinical scenarios as tools for learning. Information is provided in short sections, with most ending in a question to answer before moving on to the next section.
Working through the case studies will improve our knowledge and problem-solving skills in type 2 diabetes by encouraging us to make evidence-based decisions in the context of individual cases.
You are invited to respond to the questions by typing in your answers. In this way, you are actively involved in the learning process, which is hopefully a much more effective way to learn.
By actively engaging with these case histories, I hope you will feel more confident and empowered to manage such presentations effectively in the future.
Aabid, a 47-year-old man, has had type 2 diabetes for 5 years. He is treated with metformin 1 g twice daily, gliclazide 160 mg twice daily and atorvastatin 20 mg once daily. Although his HbA1c is 65 mmol/mol, his eGFR, cholesterol and blood pressure are normal. Aabid asks for advice on how to fast safely during the Islamic month of Ramadan.
What medical concerns might you have regarding Aabid fasting?
Jameela is a 56-year-old Muslim woman who fasts during Ramadan. Her type 2 diabetes is well-controlled with metformin 1 g twice daily and a biphasic insulin (34 units with breakfast and 28 units with her evening meal).
Is it advisable for Jameela to fast? What advice would you give her?
By working through these interactive cases, we will consider the following issues and more:
- What fasting entails and who is exempt from it.
- How to assess the risk of complications to an individual of fasting.
- How medication can be adjusted to reduce the risk of hypoglycaemia during daytime fasting.
- What to consider when altering an insulin regimen for an individual who is fasting.
Click here to access new interactive case studies
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