Ramadan & Diabetes Care Sanjay Kalra, Abdul H Zargar
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1Ramadan and DIABETES CARE2
3Ramadan and DIABETES CARE
Abdul H ZargarMD DM Member Institute Body All India Institute of Medical Sciences, New Delhi, India Former Chairman, Department of Endocrinology Director and Ex-Officio Secretary to Government Sher-e-Kashmir Institute of Medical Sciences Srinagar, Jammu and Kashmir, India Sanjay KalraMD DM Consultant Endocrinologist Bharti Hospital Karnal, Haryana, India ForewordSarita BajajMD DM President, South Asian Federation of Endocrine Societies (SAFES) Consultant Endocrinologist Director-Professor and Head of Medicine Moti Lal Nehru Medical College Allahabad, Uttar Pradesh, India Past President, Endocrine Society of India
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This book has been published in good faith that the contents provided by the contributors contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the editors specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the editors. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Ramadan and Diabetes Care
First Edition: 2014
9789350907009
Printed at
5Contributors
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7Foreword
Most books are labors of love, products of passion, and direct outcomes of determination. This passion and determination is needed from all stakeholders—editors, contributors and publishers. If lucky, a few books strike an equally loving and passionate response from readers.
This well-referenced, pleasantly laid out book, Ramadan and Diabetes Care, under the editorship of Professor Abdul H Zargar and Dr Sanjay Kalra, has all these elements, and much more. The editors and contributors have chosen a subject that impacts the lives of one-third of mankind, yet which we all practice, without any formal training in this field. The current book synthesizes all available evidence, combines it with experience, and with what the editors term as ‘logical empiricism’. It covers not only the non-pharmacological and pharmacological management of diabetes in Ramadan, but also addresses issues related to counseling, to women, and to the young as well as elderly. Detailed pathophysiological explanations are also provided in the chapter on Endocrinology of Fasting. Contributors from three continents have contributed to the book and their combined expertise makes this international masterpiece a joy to possess, and to read.
The motive of the editors and contributors seems to be a rare combination in today's world, i.e. upliftment and optimization, both of science and spirituality. With the excellent and exhaustive deliberations on the challenging subject matter done in a practical, reader-friendly manner, I am sure, this book will achieve both aims. I pray that the multiple efforts behind this book translate into safe, uplifting fasting, for millions of believers across the world.
Sarita Bajaj MD DM
President, South Asian Federation of Endocrine Societies (SAFES)
Consultant Endocrinologist
Director, Professor and Head of Medicine
Moti Lal Nehru Medical College
Allahabad, Uttar Pradesh, India
Past President, Endocrine Society of India
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9Preface
Although Islam is the second largest religion worldwide, it bears more than its fair share of the diabetes pandemic. The brunt of this modern epidemic is felt more acutely by Islamic countries, which face rapid modernization and urbanization, accompanied by drastic lifestyle changes.
The ‘Top Ten’ list (2010), for the number of people with diabetes, lists India (rank 2), Bangladesh (rank 8), Egypt (rank 9), and Indonesia (rank 10); all these countries have large populations which believe in Islam. The projected list for 2030 predicts an increase in the diabetes population in Islamic countries; while India maintains its second position, Bangladesh (rank 5), Egypt (rank 8), and Indonesia (rank 9), are joined by Pakistan at the 10th place (International Diabetes Federation, Diabetes Atlas, 5th edition).
The strain of diabetes upon Islamic nations is observed to a much greater extent when the prevalence of diabetes in adults is measured. The 2011 list ranks the Islamic countries, i.e. Kuwait (rank 3), Lebanon (rank 5), Qatar (rank 6), Saudi Arabia (rank 7), Bahrain (rank 8) and United Arab Emirates (UAE) (rank 9) among the 10 nations with highest prevalence of diabetes. The same risk names figure in the 2030 projection, albeit at different ranks (Saudi Arabia moves up to 6th place, while Lebanon, Qatar, Bahrain and UAE show a relative improvement at 7th, 8th, 9th, and 10th positions, respectively).
For adherents of Islam, Ramadan is one of the five essential pillars of religion. For those with diabetes, Ramadan presents a metabolic challenge with potential health hazards of hypoglycemia as well as hyperglycemia. With adequate preparation and planning, however, most people with diabetes can experience, pleasant and satisfying fasting experience, without any negative impact on health. In fact, fasting has been shown to have multiple biopsychosocial health benefits.
This book humbly aims to help people with diabetes experience these benefits of Ramadan, in a healthy manner. Through the evidence and experience, collated by contributors from North America, Africa, and Asia, we hope to touch health care professionals across the globe.
These health care providers, in turn, should be able to help millions of people with diabetes achieve the twin blessings of health and spiritual upliftment.
Abdul H Zargar
Sanjay Kalra
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11Acknowledgments
We express our sincere gratitude to all the contributors for their efforts. Clinicians from three continents have shared their knowledge to fill the void for a comprehensive book on Ramadan and diabetes. Their enthusiasm and energy cannot be described in words.
We would like to sincerely thank M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for the opportunity to publish this title with them. A word of thanks for Dr Neeraj Choudhary, Senior Medical Editor and Ms Madhvi Thakur, Editorial Coordinator, for all the editorial support and for tirelessly working to bring out this book in its final shape and form, in a very short span of time. The speed with which this book was coordinated across countries is a testimonial to their efficiency and to the wonders of 24/7 collaboration that technology has made possible.
Most of all, we thank our patients, who trust us with their health, and ask umpteen questions regarding fasting in Ramadan, and motivated us to plan this book.