Rationale of the Week | Best approach: Fasting During Ramadan
For last week’s practice question, we quizzed participants on best approach: fasting during Ramadan . 74% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
Question:
JL observes Ramadan and fasts from sunrise to sunset. JL has type 2 diabetes and usually takes 4 units of bolus insulin three times a day with meals and 10 units of glargine (Rezvoglar) at bedtime.
What would be the best recommendation for JL?
Answer Choices:
- See if JL can get a note from your doctor to allow eating during the day.
- Take bolus insulin when JL eats a meal.
- Monitor urine ketones at least twice a day.
- Switch glargine to degludec to decrease risk of hypoglycemia.
Getting to the Best Answer
Answer 1 is incorrect. 3% chose this answer, See if JL can get a note from your doctor to allow eating during the day. With careful planning and insulin adjustments, we can honor JL’s religious fast and cultural beliefs.
Answer 2 is correct. 76% of you chose this answer, Take bolus insulin when JL eats a meal. Yes, this is the BEST answer. If the basal insulin is dosed correctly, it won’t cause hypoglycemia while fasting. JL can hold bolus insulin during fasting, and take bolus insulin when eating.
Answer 3 is incorrect. About 9% of respondents chose this, Monitor urine ketones at least twice a day. There is no need to monitor ketones, since JL will be taking basal insulin daily and bolus insulin with meals, which will prevent ketosis.
Finally, Answer 4 is incorrect. 12% chose this answer, Switch glargine to degludec to decrease risk of hypoglycemia. There is no need to switch basal insulins. JL can stay on glargine, recognizing that it may need to be adjusted.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
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