AACE MENA 2025-Adrenal Replacement in Ramadan

Video Transcription

Video Summary

Dr. Peshir discussed adrenal replacement during Ramadan fasting, which involves abstaining from food, drink, and medication from dawn to sunset, lasting 11-21 hours depending on location. Patients with adrenal insufficiency face risks such as hypoglycemia, dehydration, and adrenal crisis while fasting. Studies reveal that many patients attempt fasting but often experience complications like fatigue, headache, and hypoglycemia, especially in the first week. Hydrocortisone is commonly used for replacement but has a short half-life; alternatives like prednisolone offer longer action. Research shows both hydrocortisone and prednisolone can be safely used during Ramadan, though dosage adjustments are necessary. Guidelines recommend pre-Ramadan risk assessment, patient education, and close monitoring, especially early in fasting. Patients should eat balanced pre-dawn meals, maintain hydration, avoid strenuous activity, and know when to break their fast if complications arise. While fasting poses increased risks, with proper management and education, many with adrenal insufficiency can fast safely during Ramadan.

Keywords

Adrenal insufficiency

Ramadan fasting

Hydrocortisone

Prednisolone

Hypoglycemia

Patient education