Annals of Medicine

Ramadan is the ninth month of the Islamic lunar calendar (Hijri). Adult Muslims fast from dawn to sunset during Ramadan as a religious obligation. Fasting during Ramadan has notable effects on the endocrine system, leading to alterations in hormone levels and potentially impacting several endocrine diseases. Extended fasting can influence the secretion and regulation of insulin, potentially exacerbating diabetes mellitus. Additionally, cortisol rhythms may be altered due to changes in meal timings, which can have implications for individuals with adrenal disorders. Thyroid function might also be impacted, given the intricate connection between metabolism and thyroid hormones. Pituitary hormones can also be altered due to changes in sleep and meal timings. Patients with pituitary, adrenal, and thyroid disorders, along with those with diabetes, face unique challenges related to their fasting routine, changes in metabolism, medication dose and time adjustments, and compliance, among other issues.

The long hours of fasting present unique challenges for patients with diabetes, given the rising global prevalence of diabetes mellitus (DM), particularly among Muslims. Existing guidelines, such as those from the International Diabetes Federation (IDF) and Diabetes and Ramadan (DaR) International Alliance, provide DM management advice during Ramadan but are often based on limited evidence. Extended fasting can disrupt glucose regulation, leading to complications such as hypoglycemia, hyperglycemia, diabetic ketoacidosis (DKA), and other glucose imbalances. Changing meal patterns can cause hyperglycemia, leading to a cycle of poor diabetes control when not appropriately managed. Adjusting diabetes medication regimens during Ramadan is another challenge, especially given the uncertainty around the effectiveness of new-generation insulins and non-insulin medications during fasting. Safe fasting requires close collaboration with healthcare professionals, consistent blood glucose monitoring, and proper self-management education.

The complex interplay between Ramadan fasting and its implications for endocrine diseases necessitates rigorous scientific investigation. The multifaceted endocrine adaptations to prolonged fasting have not been comprehensively elucidated, particularly in the context of chronic endocrine disorders. Existing literature, while providing preliminary insights, lacks the robustness required for definitive clinical recommendations.

This Article Collection will focus on safe fasting in the month of Ramadan among patients with endocrine disorders. We aim to solicit articles on (but not limited to) the following subtopics:

• Management of diabetes mellitus and its complications in Ramadan
• Management of adrenal disorders in Ramadan
• Management of pituitary disorders in Ramadan
• Management of thyroid disorders in Ramadan
• The role of nutrition and dietary patterns in controlling diabetes during Ramadan
• The use of technology to manage diabetes mellitus during Ramadan

The following Article Types will be considered: basic, clinical, and epidemiological original research, meta-analyses, systematic and scoping reviews, narrative reviews, and commentaries.

When submitting your article, please select the section, 'Endocrinology', and the Article Collection, 'The Management of Endocrine Disorders in Ramadan: Current Challenges and Way Forward' from the drop-down menu on the submission system.

 

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Annals of Medicine is an online, open-access, international journal publishing across all areas of medicine and is part of our Elevate Series. This means that you will receive a concierge-level publishing experience, including dedicated support from our expert in-house Editorial team, with guaranteed response times of within 48 hours, an initial decision on whether your article will be peer-reviewed within 5 working days, and a first decision on your research within an average of 22 working days.

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