Diabetes mellitus and Ramadan in Algeria.

Ramadan, one of the five pillars of Islam, is a holy month in Algeria where diabetes mellitus (DM) is more frequent in urban areas with a frequency which varies from 8 to 16%. DM complications are broadly as frequent as in developed countries, except for neuropathy which seems more frequent. Despite contraindications which are regularly explained to our patients and despite the flexible side of Islam toward chronic diseases, most Algerian people with DM insist on fasting. Not fasting is considered a sin and shameful. There are also other reasons put forward by diabetic persons, such as very strong religious faith, habit of fasting together with the whole family since an early age, solidarity with the family, friends, and neighbors, and finally and probably because of the desire to appear "normal" and share a festive and a spiritual atmosphere of Ramadan. As in other Muslim countries, severe hypoglycemia the main motive of hospitalizations during the holy month, ketoacidosis, dehydration, orthostatic hypotension and thrombosis are some of the complications which Algerian people with DM are exposed to when fasting.