Month: February 2026

We are proud to share the successful conclusion of the Symposium on Diabetes in Ramadan, a historic and impactful event held in Faisalabad. This landmark gathering brought together distinguished healthcare leaders, clinicians, and academic experts with one shared mission: to improve diabetes care and ensure safe fasting practices during the holy month of Ramadan.

A Historic First for Pakistan

The symposium marked a groundbreaking achievement for the country — the official unveiling of the Instruction Manual for Diabetes in Ramadan. This comprehensive guide is a collaborative masterpiece developed by:

• LDF
• FMU
• WPG Scotmann Pharmaceuticals

This manual is designed to provide evidence-based, practical, and locally relevant guidance for healthcare providers and patients managing diabetes during Ramadan. It addresses risk stratification, medication adjustments, insulin management, dietary planning, and lifestyle modifications — all tailored to the unique fasting practices observed in Pakistan.

The launch of this manual represents a major step forward in structured diabetes education and reflects a strong commitment to patient safety and community health.

A Vision for the Future: 5-Year Strategic MOU

To ensure sustainable impact beyond a single event, a strategic five-year Memorandum of Understanding (MOU) was signed between WPG, Scotmann, and LDF.

This long-term collaboration commits to:

• Continuous healthcare provider (HCP) training programs
• Patient education campaigns before Ramadan each year
• Community awareness seminars across Pakistan
• Research and data collection to improve diabetes care models
• Development of updated guidelines aligned with global standards

This half-decade partnership sets the foundation for transforming Ramadan-focused diabetes management into a structured national initiative.

Distinguished Leadership and Academic Excellence

The symposium was honoured by the presence of eminent academic and medical leaders whose guidance elevated the event to a truly national milestone.

• Chief Guest: Prof. Dr. Zafar Ali Choudhry (Vice Chancellor, FMU)
• Patron-in-Chief: Prof. Dr. Amir Shokat
• Guest of Honour: Prof. Dr. Zahid Yaseen Hashmi
• Chairman: Prof. Dr. Abdul Hafeez Choudhry
• Vice Chairman: Dr. Ahmad Shahzad (President LDF / PCDA Punjab)

Their presence reinforced the importance of institutional collaboration in addressing one of Pakistan’s most pressing public health challenges — diabetes management during fasting.

Scientific Excellence: Evidence-Based Discussions

The scientific sessions were the heart of the symposium, featuring in-depth, clinically relevant presentations delivered by leading experts in endocrinology and internal medicine.

1️⃣ Gestational Diabetes

Speaker: Dr. M. Irfan
The session highlighted the complexities of managing gestational diabetes during Ramadan and emphasized individualized risk assessment. Special attention was given to maternal and fetal safety, glucose monitoring, and when fasting should be discouraged.

2️⃣ Insulin Management During Ramadan

Speaker: Dr. Sohail Anjum
This session focused on insulin dose adjustments, timing modifications between Suhoor and Iftar, and preventing hypoglycaemia. Practical algorithms were discussed to help physicians optimize insulin regimens safely.

3️⃣ Lifestyle Modifications

Speaker: Dr. Usman Musharraf
Dietary planning, hydration strategies, physical activity recommendations, and sleep patterns were discussed as crucial components of safe fasting. The session emphasized patient education as the cornerstone of prevention.

4️⃣ Fasting with Diabetes: Risk Stratification

Speaker: Dr. Ahmad Shahzad
One of the most impactful sessions outlined clear categorization of patients into low-risk, moderate-risk, and high-risk groups, based on international diabetes guidelines.

• High-risk patients: Strongly advised not to fast due to severe hypoglycaemia risk, uncontrolled diabetes, advanced complications, or pregnancy with poor glycaemic control.
• Moderate-risk patients: May fast with strict medical supervision, medication adjustment, and regular glucose monitoring.
• Low-risk patients: Can fast safely with routine monitoring and pre-Ramadan medical consultation.

5️⃣ Oral Medication Adjustment

Speaker: Prof. Dr. Amir Shokat
This session detailed how to safely adjust oral hypoglycaemic agents, reduce hypoglycaemia risk, and ensure stable blood glucose levels during prolonged fasting hours.

A Collaborative Step Toward Safer Ramadan

Pakistan ranks among the countries with a high prevalence of diabetes, making structured Ramadan-focused education critically important. Many patients choose to fast despite medical advice, highlighting the urgent need for culturally sensitive and medically sound guidance.

This symposium addressed that need directly — bridging the gap between religious practice and clinical safety.

The event also fostered collaboration between academia, healthcare institutions, and the pharmaceutical sector, ensuring a multi-disciplinary approach to diabetes care.

Gratitude to Our Panel of Experts

We extend our heartfelt appreciation to our esteemed panel of experts and speakers whose dedication, research, and experience contributed to the success of this historic initiative. Their invaluable insights will help make Ramadan safer for thousands of patients living with diabetes.

We also thank all healthcare professionals, attendees, organizers, and partners who made this event possible.

Moving Forward

The unveiling of the Instruction Manual is not the conclusion — it is the beginning of a national movement toward structured, evidence-based diabetes care during Ramadan.

With a strong five-year roadmap, institutional backing, and expert leadership, this initiative promises to:

• Reduce diabetes-related complications during Ramadan
• Empower healthcare providers with standardized protocols
• Educate patients about safe fasting practices
• Promote early medical consultation before Ramadan

Together, we are shaping a future where faith and health go hand in hand — ensuring that patients can observe Ramadan safely and responsibly.

Presented by Lyallpur Diabetes Foundation in Collaboration with Faisalabad Medical University

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Ramadan is a sacred and spiritually uplifting month for Muslims around the world. Fasting from dawn (Suhoor) to sunset (Iftar) is an important act of worship. However, for individuals living with diabetes, fasting can present significant health challenges if not properly planned.

This guide is designed for patients and families to understand how to fast safely with diabetes, who can fast, who should not fast, and what precautions must be taken before and during Ramadan.

Why Is Fasting Risky for People with Diabetes?

During Ramadan, long hours without food and drink can affect blood sugar levels. A person with diabetes may experience:

• Hypoglycemia (low blood sugar)
  
• Hyperglycemia (high blood sugar)
  
• Dehydration
  
• Diabetic ketoacidosis (especially in Type 1 diabetes)
  
• Blood clots due to dehydration
  

Because of these risks, fasting is not automatically safe for everyone with diabetes. Islam provides exemptions for people whose health may be harmed by fasting. Health and safety always come first.

The Importance of Pre-Ramadan Medical Evaluation (4–6 Months Before Ramadan)

One of the most important recommendations is that patients must consult their doctor 4 to 6 months before Ramadan.

Why so early?

Because doctors need time to:

• Review blood sugar control (HbA1c levels)
  
• Assess complications (kidney, heart, nerve, or eye disease)
  
• Adjust medications
  
• Modify insulin doses
  
• Educate patients on monitoring blood glucose during fasting
  
• Provide a personalized fasting plan
  

Early evaluation allows proper planning and reduces the risk of emergency complications during Ramadan.

Families should encourage their loved ones with diabetes to schedule this consultation well in advance.

Risk Stratification: Who Can Fast and Who Cannot?

Not all diabetic patients are the same. Doctors classify patients into low-risk, moderate-risk, and high-risk categories.

This risk assessment determines whether fasting is safe.

1. High-Risk Patients – SHOULD NOT FAST

High-risk patients are strongly advised not to fast because fasting may cause serious harm.

This group includes:

• Patients with Type 1 diabetes with poor control
  
• Patients with frequent hypoglycemia
  
• Patients who had severe hypoglycemia in the last 3 months
  
• Patients with diabetic ketoacidosis recently
  
• Pregnant women with diabetes
  
• Patients with advanced kidney disease
  
• Patients with serious heart disease
  
• Elderly patients with multiple health problems
  
• Patients who are unable to monitor blood glucose regularly
  

For these individuals, fasting can be life-threatening. Islam permits them not to fast and instead offer alternative religious options such as fidya (feeding the poor).

Families must understand that choosing not to fast for medical reasons is not a lack of faith — it is a protection of life.

2. Moderate-Risk Patients – May Fast With Strict Guidelines

Moderate-risk patients can fast, but only with medical supervision and clear precautions.

This group may include:

• Type 2 diabetes patients with moderate control
  
• Patients on insulin with stable blood sugar
  
• Patients taking multiple oral medications
  
• Patients with mild complications
  

These individuals must follow strict guidelines:

A. Medical Consultation Is Mandatory

Medication and insulin doses often need adjustment. For example:

• Long-acting insulin doses may need reduction
  
• Timing of oral medications may change
  
• Sulfonylureas may require caution due to hypoglycemia risk
  

Never change medication doses without consulting a doctor.

B. Regular Blood Glucose Monitoring

Many people think checking blood sugar breaks the fast. It does not.

Patients should check:

• Before Suhoor
  
• Midday
  
• Before Iftar
  
• Whenever symptoms occur
  

If blood sugar falls below 70 mg/dL (3.9 mmol/L), the fast must be broken immediately.

If blood sugar rises above 300 mg/dL (16.7 mmol/L), the fast should also be broken.

C. Nutrition Guidelines

At Suhoor:

• Eat complex carbohydrates (whole grains, oats)
  
• Include protein (eggs, yogurt, lentils)
  
• Avoid sugary foods
  
• Drink adequate water
  

At Iftar:

• Break fast gently (1–2 dates maximum if blood sugar allows)
  
• Avoid fried foods
  
• Avoid large sugary desserts
  
• Eat balanced meals
  
• Do not overeat
  

Overeating at Iftar can cause dangerous blood sugar spikes.

D. Hydration Is Essential

Dehydration increases the risk of blood clots and kidney problems. Patients should drink sufficient fluids between Iftar and Suhoor.

Avoid:

• Excessive caffeine
  
• Sugary drinks
  

E. Physical Activity

Light to moderate activity is acceptable. However:

• Avoid heavy exercise during fasting hours
  
• Taraweeh prayer counts as moderate physical activity
  

3. Low-Risk Patients – Can Fast Safely

Low-risk patients are generally:

• Well-controlled Type 2 diabetes patients
  
• Patients on diet control only
  
• Patients on metformin alone
  
• Patients without complications
  

These individuals can usually fast without major problems, but they should still:

• Consult a doctor before Ramadan
  
• Monitor blood glucose regularly
  
• Follow healthy dietary practices
  
• Stay hydrated
  

Even low-risk patients should not assume fasting is automatically safe every year. Health status can change.

Warning Signs: When to Break the Fast Immediately

Every diabetic patient must know the danger signs.

Break the fast if you experience:

• Sweating
  
• Dizziness
  
• Shaking
  
• Confusion
  
• Severe weakness
  
• Blurred vision
  
• Fainting
  
• Severe headache
  
• Chest pain
  
• Extreme thirst
  

Breaking the fast for health reasons is allowed and necessary.

Special Considerations for Insulin Users

Patients using insulin must be particularly cautious.

Doctors may:

• Reduce basal insulin dose
  
• Adjust timing to Iftar
  
• Modify rapid-acting insulin at meals
  

Skipping insulin to avoid hypoglycemia is dangerous and can lead to diabetic ketoacidosis.

Close monitoring is essential.

The Role of Family Support

Family members play a crucial role during Ramadan.

They should:

• Encourage medical consultation months before Ramadan
  
• Help prepare healthy Suhoor and Iftar meals
  
• Remind patients to check blood sugar
  
• Recognize warning signs of low or high blood sugar
  
• Support the decision if fasting is medically discouraged
  

Ramadan is a time of unity and compassion. Protecting a loved one’s health is part of that compassion.

Preparing Early: A Ramadan Action Plan

Here is a simple timeline for patients:

4–6 Months Before Ramadan

• Schedule doctor appointment
  
• Perform blood tests (HbA1c, kidney function)
  
• Review medications
  
• Create fasting plan
  

1 Month Before Ramadan

• Practice modified meal timings
  
• Monitor blood sugar more frequently
  
• Adjust lifestyle gradually
  

During Ramadan

• Follow medical advice strictly
  
• Monitor blood glucose daily
  
• Break fast if needed

Final Message: Faith and Health Go Together

Ramadan is a month of spiritual renewal, discipline, and mercy. For individuals with diabetes, it must also be a month of medical awareness and preparation.

• High-risk patients should not fast.
• Moderate-risk patients may fast with strict supervision.
• Low-risk patients can fast with routine precautions.
• All patients must consult their doctor 4–6 months before Ramadan.

Protecting health is a responsibility. Fasting should strengthen faith — not endanger life.

Through education, early planning, and community collaboration, we can ensure a safer and healthier Ramadan for everyone.

For more information, attend our upcoming seminar and stay connected with Lyallpur Diabetes Foundation for updated local guidelines and patient support initiatives.

Your health is a trust. Safeguard it wisely.