Ghouri Nazim, Hussain Sufyan, Mohammed Ruzwan, Beshyah Salem Arifi, Chowdhury Tahseen A, Sattar Naveed, Sheikh Aziz
University of Glasgow, Institute of Cardiovascular and Medical Sciences, Glasgow, UK.
Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
BMJ Open Diabetes Res Care. 2018 Jun 4;6(1):e000520. doi: 10.1136/bmjdrc-2018-000520. eCollection 2018.
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.
很大一部分穆斯林人口在斋月期间禁食。对于使用胰岛素和胰岛素促泌剂的糖尿病患者而言，斋月禁食会增加低血糖风险。因此，糖尿病患者禁食与驾车的结合带来了具有挑战性的情况，对这些个体及其医护人员具有法律影响。这篇新颖的、叙述性的、非系统性综述参照关于糖尿病患者驾车的世俗法律指南，探讨了在禁食期间应对低血糖的重要性。我们讨论了伊斯兰教中与禁食和驾车相关的宗教方面。虽然对于禁食的个体在糖尿病与驾车方面没有明确的指导或法律立场，但伊斯兰教法提供了一个解决此问题的逻辑框架。医护人员需要与计划禁食的糖尿病患者就这个经常被忽视的话题展开并推动讨论，以尽量减少对公众造成伤害的可能性。对于一些个体来说，驾车时可能应避免禁食，并且当一个人依赖驾车为生时，最好采取这种与宗教兼容的立场。最终，需要对禁食和驾车时的血糖控制与管理进行进一步研究，以及关于这个话题的正式法律指南，以保护医护人员和公众免受糖尿病患者禁食驾车带来的潜在危险。
