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Diabetes, driving and fasting during Ramadan: the interplay between secular and religious law
  1. Nazim Ghouri1,
  2. Sufyan Hussain2,3,
  3. Ruzwan Mohammed4,
  4. Salem Arifi Beshyah5,
  5. Tahseen A Chowdhury6,
  6. Naveed Sattar1,
  7. Aziz Sheikh7
  1. 1 University of Glasgow, Institute of Cardiovascular and Medical Sciences, Glasgow, UK
  2. 2 Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK
  3. 3 Department of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
  4. 4 Solas Foundation, Glasgow, UK
  5. 5 Institute of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
  6. 6 Department of Diabetes and Metabolism, Barts Health NHS Trust, London, UK
  7. 7 Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Nazim Ghouri; nazim.ghouri{at}


A large proportion of the Muslim population fasts during Ramadan. The risk of hypoglycemia is increased with fasting during Ramadan in people with diabetes who are on insulin and insulin secretagogues. Therefore, the combination of fasting with diabetes and driving presents a challenging situation, with legal implications for such individuals and their healthcare professionals. This novel, narrative, non-systematic review discusses the importance of addressing hypoglycemia in fasting with reference to secular legal guidance on driving with diabetes. We discuss religious aspects relating to fasting and driving in Islam. While there is no clear guidance or legal position on diabetes and driving for individuals who are fasting, Islamic law provides a logical framework to address this. Healthcare professionals need to raise and facilitate discussions on this often-overlooked topic with people with diabetes who are planning on fasting to minimize the potential for public harm. For some individuals fasting perhaps should be avoided when driving and that this religiously compatible position would best be adopted when one is dependent on driving for livelihood. Ultimately further research on glycemic control and management when fasting and driving, as well as a formal legal guidance on this topic, is required to safeguard healthcare professionals and the public from the potential dangers of driving with diabetes and fasting.

  • Ramadan
  • fasting
  • hypoglycaemia
  • driving
  • secular

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent Not required.

  • Contributors NG conceived the idea. NG, SH, RM SAB and TC drafted the original manuscript. All authors critically revised the manuscript and approved the final version.

  • Data sharing statement Data sharing is not applicable to this article as no new data were created or analyzed in this study.