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Diabetes management during Ramadan
Ramadan Mubarak 2024
Ramadan is soon upon us, and for those who have diabetes and wish to fast we strive to support you so that you can fulfil your fasting safely without compromising your health.
This is just a reminder that it is important to get advice in advance regarding how to manage medications during Ramadan. There is normally Ramadan teaching sessions held at Mile End Hospital, the information however will be general therefore if you have lots of medications or dosset boxes it’s best to seek personal advice from your practice.
Islam gives exemptions from fasting if you have complex medical problems that are compromised by fasting for long periods. Those that are unable to fast during Ramadan can fast during the winter months when the days are short or can donate money for charity instead of fasting (Fidya & Kaffarah).
Main problem during Ramadan is avoiding hypoglycaemia (low sugar levels) and avoiding acute kidney injury due to lack of water intake throught the day.
People with Type 1 diabetes and those with renal failure, pregnant, frail or with other medical conditions where fasting will affect them negatively are advised against fasting.
During Ramadan, medications that are normally taken at breakfast time are usually taken at Iftar and the night medications are usually taken at Sehri time. For those with lunchtime medications, it’s important to ask when to take the medication instead of assuming you can just stop taking it. Due to the short periods when one can eat and drink, some medications need reducing but not all need stopping.
All diabetes medications including insulin which are taken at Iftar should be taken during the meal or just after the meal to prevent hypo happening as one would have been fasting for over 12 hours. This is why it is extremely important to get help from one of the diabetes nurses on dosing in advance, you can do this onlinbe by submitting a request to the admin team to call you back using this link.
It is important to remember to switch back to taking your medications how you normally take them after Ramadan is over.
Hoping you fulfil your wishes for Ramadan 2024
Bonnie Mpofu (Diabetes Specialist Nurse)
Jubilee Street Practice
Men’s Wellbeing Group
Important Dates
Jubilee Street Practice Closure Dates:
Please note the Jubilee Street Practice will be closed from 12.30pm to allow staff to attend a Protected Learning Time on the following dates:
Thursday 16th May 2024
Tuesday 11th June 2024
Thursday 11th July 2024
We will re-open the following mornings at the usual time.
For any urgent medical queries please call 111, or in an emergency call 999.
For a full list of closure dates up to December 2024 please see our ‘JSP what’s on calendar’
Diabetes and Ramadan
There are a couple of webinars and workshops that are being organised around how to safely manage your diabetes during Ramadan.
The in-person workshop being organised by Diabetes UK is for women only and you can find more information on the following leaflet.
The online webinar is being organised by the British Islamic Medical Association (BIMA). You can sign up to their webinar by clicking the image below and filling out an online form.
Requesting Repeat Prescriptions
The quickest and easiest way to order your repeat prescription is via the NHS App – search your app store or go to https://www.nhs.uk/using-the-nhs/nhs-services/the-nhs-app/. Using the app, you can order medications, view your medication records and book telephone call backs.
Remember to nominate your chosen pharmacy so that we can send your prescription electronically. During the coronavirus pandemic this is especially important for reducing non-essential visits to the practice, helping us to ensure social distancing can be maintained.
Other ways you can order your repeats:
- Ask reception for your PIN number for patientaccess.com
- Request through your regular pharmacy
- Place your repeat slip in the box in the entrance area
PLEASE NOTE THAT FOR SAFETY REASONS AND TO KEEP OUR PHONE LINES FREE, WE ARE UNABLE TO TAKE REPEAT PRESCRIPTION REQUESTS OVER THE PHONE.
Medicines Available ‘Over the Counter’
General Practices in England will generally not be able to give you an NHS prescription for medicines that are available to buy in pharmacies and supermarkets.
NHS England changed the rules on treatments for minor and self-limiting conditions in 2018 with the aim of prioritising prescriptions for more serious or long-term health problems. Prior to this the NHS was spending around £136 million a year on prescriptions for treatments that can be purchased over the counter.
Please ask your local pharmacy for advice if you may need treatment for conditions such as:
• coughs, colds & sore throats • mild to moderate hay fever • conjunctivitis • dry eyes • dandruff • nappy rash • cradle cap • teething • travel sickness • head lice • indigestion • dry skin • warts and verrucae • insect bites • ear wax • mouth ulcers • threadworms • athlete’s foot
Exceptions can be made at the discretion of the treating practitioner, for example where over the counter treatments have not worked, in more severe forms of the illness, or where the licence does not allow the product to be sold to certain groups e.g. women who are pregnant or children under a certain age. Please speak to the practice if you need further information.
Practice Policies on Prescribing
Jubilee Street Practice has a comprehensive repeat prescribing policy to ensure the safety of our patients and to make sure we are using medicines appropriately. Our policy is regularly reviewed to ensure we keep up to date with the latest guidance.
Key information for our patients:
- Our standard repeat prescription duration is up to two months (usually this will be 56 days). In exceptional circumstances, NHS England allows us to issue up to a 12 week maximum supply.
- We aim to review all prescription requests within two working days but if your request is straightforward they will often be issued earlier than this.
- If you request a medicine that is not on your repeat list, or order it earlier than it appears to be due, your request may be rejected and you may be contacted by the practice and asked to provide more information. This will usually be via text message.
- For safety reasons, some medications may not appear on your repeat list. This may be because we need to review how well they are working for you with regular monitoring, or because they are a higher risk or ‘controlled’ medication.
- Please be aware that ‘Repeat dispensing’ refers to a batch prescription that you do not need to order each time. Normal ‘repeat’ medications will need to be requested each time you require them.
- It is best practice for ALL repeat medications to be reviewed on at least an annual basis. Sometimes your GP or pharmacist will be able to do this from your notes but we may also call you to discuss or ask you to attend an appointment if you take more than 10 medicines regularly or take medicines that require blood tests or other monitoring. This is an opportunity to ask questions about your medicines and to discuss how well they are working for you.
Why am I being advised to reduce or stop my stomach acid medication?
Proton Pump Inhibitors (or PPIs) are a group of medicines used to reduce stomach acid and include omeprazole, lansoprazole, esomeprazole and pantoprazole. These medicines are very commonly prescribed but many patients continue taking them for longer than they may need. Usually a course of two to three months is sufficient to help heartburn or indigestion to settle.
As with any prescription medication, PPIs can cause side effects which are more likely if you take a high dose or use them for a long period of time. More and more evidence is coming out that suggests this group of medications may be linked to more problems than we knew about previously. We are therefore re-assessing which of our patients these medicines remain the best choice for.
What are the possible risks from long-term use of a PPI?
- Increased risk of serious stomach infections including Clostridium difficile
- Increased risk of bone fractures
- Decreased absorption of nutrients including magnesium, calcium, and vitamins
- Reduce the effectiveness of other medicines you may take including medicines used to prevent heart attack and stroke
- May increase risk of kidney disease, pneumonia, dementia and certain cancers – more research is being done on all these possible links.
Always speak to your GP or pharmacist before stopping prescribed medicines. PPIs should be reduced slowly to minimise rebound symptoms. If you have a history of stomach ulcers or bleeding, or have severe symptoms it is likely that continuing your PPI is the best option – your GP can help you to make this decision.
For information on what you can do to help with heartburn and indigestion yourself, see our Self Care and Common Conditions section of the website for some useful links.
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