Table 3.

Key aspects to cover during consultation

Aspects	Advice
SMBG	- Importance and frequency of SMBG; identification, management and reporting of hypoglycaemia and hyperglycaemia
Diet	- Avoid foods of high glycaemic index; avoid indulgent eating
Fluids and meal planning	- In temperate countries where fasting is prolonged or when temperatures are hot, adequate non-sugary fluid intake is advised
Exercise	- Regular light-to-moderate exercise is advised; it can be done anytime, but preferably a few hours before Iftaar or just after a light Iftaar  - The special night prayer (Taraweeh), which can involve standing for prolonged periods, is a good form of exercise for those who participate. This occurs within a congregation in the mosque and is a form of exercise. Patients should keep treatment for hypoglycaemia
Smoking	- Smoking invalidates a fast. Ramadan is an opportunity to promote smoking cessation
Medication review	- Optimization for Ramadan fasts with particular importance given to risk of hypoglycaemia, duration of fasts and non-diabetes medication, such as diuretic usage
When to break the fast	- Blood glucose < 4 mmol/L(< 5 mmol/l if driving necessary)  - Blood glucose > 16.7 mmol/L at any time during the fast (or pre-agreed threshold with HCP)  - Development of acute intercurrent illness causing significant physical, mental or physiological compromise  - General deterioration in health causing significant physical, mental or physiological compromise
Driving/travel	- Determine if driving is required for work and/or social activities and further stratify patients according to risk in relation to risk of harm when fasting  - If driving whilst fasting is going to occur, give relevant advice relating to hypoglycaemia that is compatible with both secular and religious law
Healthcre support	- A HCP should be identified for advice and support

HCP Healthcare professional, SMBG Self-monitoring of blood glucose