الفهرس 
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Abstract
Fasting in Ramadan is obligatory for all healthy Muslim adults. No food or drink may be consumed between dawn and sunset.Certain groups are exempt from fasting temporarily or permanently including the sick, the elderly, the travellers and the expecting and nursing mothers.However, many of those who are exempt may wish to observe the fast. It is the responsibility of the medical professional to empower patients to make an informed choice and, if possible, an evidence-based decision.
(The Holy Quran. Sura 2: Verses 183-185)
(Salti I et al 2004)
Our aim of this study was to evaluate the concept of diabetics in the community about fasting in Ramadan, its risks, and management, in order to build up health education programs depending on points of shortage.
This study was carried out at Sohag University Hospital to cover a sample of 1000 of diabetic subjects attending our outpatient clinic. A standardized questionnaire was the basis of the interview, and covered including a detailed medical history, including type and duration of diabetes, complications , drug treatment, ,level of glycaemic control and frequency of hypo- or hyperglycemic events during Ramadan, including history of fasting ,source and nature of counseling received.
The following results were obtained of our study:
• Our study was conducted on 1000 diabetic patients; six of them were excluded as they never fast. The majority of patients (n = 859) (86.4%) had continued to fast during Ramadan.
• 23.5% of patients were type1 and 76.5% were type2.
• The Fasting groups were significantly younger (50.2 ± 11.8) versus (52.16 ± 24.7) for non fasting group.
• They were more frequently treated with oral anti-diabetic drugs alone (47% versus 14% respectively) and insulin alone (48.5% versus 37% respectively).
• Only 41% of patients had discussed the feasibility of fasting and alarming symptoms to break the fast with their doctor.
• Hyperglycemia was observed in 25% of non fasting group versus 31% of fasting group.
• 72% of fasting group does not change their drug regimens, also there about 60% does not experience changes of diet and weight.
• Three pregnant ladies complete fasting for 25 days although frequent hypoglycemic events take place for them. Another pregnant lady continued to fast for 12 days.
The large proportion of both type 1 and type 2 diabetic subjects who fast during Ramadan represent a challenge to their physicians. There is a need to provide more intensive education before fasting, to disseminate guidelines, and to propose further studies assessing the impact of fasting on morbidity and mortality.