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Copyright © 2026 | MyWay Digital Health

Debbie Wake test

Debbie is the CEO and Clinical Lead for MyWay Digital Health, and a Consultant Diabetologist working in NHS Lothian. Debbie also works at the University of Edinburgh as a Clinical Reader in Medical Informatics and Diabetes Care & Education.

She is passionate about improving the lives of people with diabetes through education and data driven care.

Dr Athari Alsulami

Dr.Athari Alsulami is a Diabetes and Family Medicine Consultant. She is also an Assistant Professor at Fakeeh College for Medical Specialties.

Dr Abdul Rahman

Dr Abdul Rahman is an NHS GP in Nottingham (MRCGP, 2019). She is a member of the British Islamic Medical Association (BIMA) and British Society of Lifestyle Medicine (BSLM) and currently undergoing the BSLM Core Accreditation in Lifestyle Medicine. She has an MSc in Sports and Exercise Medicine (Exeter, 2010) focusing on physical activity.

Dr Salman Waqar

Salman is a general practitioner in and an honorary academic at Imperial College London. He is the President of the British Islamic
Medical Association (BIMA), an award-winning voluntary non-profit association of Muslim health professionals that have been addressing health inequalities for over a decade.

He has an interest in faith in healthcare and published several peer-reviewed papers on Ramadan clinical guidelines, as well as on cancer screening and organ donation in Muslim communities. He is the co-editor of the BIMA Ramadan Compendium, which provides an evidence-based patient-centred decision making tool to enable a safer Ramadan for a variety of health conditions. He completed an NIHR Fellowship at the University of Oxford, where he also obtained a scholarship for an MSc in Evidence Based Healthcare.

He has a variety of educational roles as a postgraduate GP Training Programme Director for Health Education England, an examiner for the GMC PLAB exam and the final year MBBS at St Georges London, and a Faculty Education Lead for Royal College of GPs.

Assoc Prof. Nazim Ghouri

Nazim graduated from Edinburgh University, and he was appointed as a consultant in 2015 at the Queen Elizabeth University Hospital and is also an Honorary Clinical Associate Professor at the University of Glasgow. During his specialist training, he completed his MD thesis titled ‘The cardiometabolic phenotype of UK South Asian Men’ at Glasgow University.

Nazim has published around 50 papers and he has also studied Sacred Islamic knowledge with a contemporary focus. His research and teaching interests relate to his clinical and academic expertise, as well as ethnicity and faith (particularly fasting in Ramadan). He has published novel papers in high impact journals and spoken nationally in these areas. He is one of the main authors of the recently published ‘Guide to organ donation and Muslim beliefs’ on behalf of the Scottish Government.

Finally, he is the joint senior editor of the British Islamic Medical Association Ramadan compendium – comprehensive informative guidance on the management of patients during Ramadan for HCPs covering a range of specialties.

Dr Harni Bharaj

Dr Harnovdeep Singh Bharaj is a Consultant Physician in General Medicine, Diabetes, Endocrinology and Metabolism at Bolton NHS Foundation Trust and was formerly a clinical lecturer at the University of Manchester. Dr Bharaj pioneered the role of lay educator and diabetes support nurses for South Asians and developed a twilight multidisciplinary clinic for young people with diabetes and a nurse-led diabetes clinic; both initiatives improved access and reduced inequalities in health care delivery.

Dr Bharaj is a Member of the Greater Manchester Structured Patient Education Steering Group; a Member of the Diabetes UK Community Education Insight Advisory Group, and Chair of the North West Youth Diabetes Steering Group.

Dr Bharaj was awarded an MBE in January 2021 in recognition of his services to people with diabetes in the South Asian community

Dr Scott Mackenzie

Scott is a medical doctor and clinical academic practicing in Edinburgh, Scotland. Scott currently works as a Clinical Fellow in Digital Health where he helps develop and evaluate online education to improve care for people with diabetes.

Alison Campbell

Alison Campbell is the Learning Resource Administrator for MyWay Digital Health and studied Cell Biology at University. Alison supports the development of our eLearning courses and educational resources on our public access websites.

Kirsten Cumming

Kirsten is the Clinical Education Lead for MyWay Digital Health and studied Food, Nutrition & Health at University. Kirsten is passionate about helping people living with diabetes as her sister was diagnosed with Type 1 diabetes when she was 11.

Medication Guidance
  • Metformin tablets, on their own will not cause low glucose (hypoglycaemia). But if you feel unwell while you are fasting, you can consider reducing the dose or changing the timing of when you take them. The largest dose should be taken at Iftar, so that they work when you are eating.
  • Acarbose: If you take acarbose and you feel unwell while you are fasting, you can consider reducing the dose or changing the timing of when you take them. If you continue to take them, the largest dose should be taken at Iftar, so that they work when you are eating.
  • Sulphonylureas (e.g. gliclazide, glibenclamide, glimepiride, Dimicron MR): If you take sulphonylurea tablets or prandial glucose regulators (repaglinide, metaglinide, nateglinide), be aware that these can cause low glucose (hypoglycaemia) when you are fasting, which could make you feel ill. It is likely that your Suhoor dose may be reduced but the same dose can be taken at Iftar. The older drugs e.g glibenclamide should be avoided. Do talk to your doctor for specific treatment adjustment advice for you.
  • Pioglitazone tablets do not cause low glucose (hypoglycaemia) when taken alone.  No dose modification is required during Ramadan but you should take this medication at Iftar rather than Suhoor.
  • DPP4 inhibitors (also known as ‘gliptins (e.g. sitagliptin, saxagliptin) generally do not cause low glucose (hypoglycaemia) on their own. In addition, as they are taken once daily, you can continue to take them as normal or if it is easier, you can take them with food, e.g. at Iftar.
  • SGLT2 inhibitors (e.g. dapagloflozin, empagloflozin, canagloflozin) generally do not cause low glucose (hypoglycaemia) on their own so you can continue to take them as normal, take a reduced dose or if it is easier, take them with food, e.g. at Iftar. Increasing fluid intake during the non-fasting hours is recommended.
  • Non-insulin injections such as GLP-1 agonists (usually given by weekly or daily injections, e.g. Trulicity, exenatide, liraglutide, semaglutide). These do not cause low glucose (hypoglycaemia) on their own so it may be possible to continue to take these as long as you monitor your blood glucose levels closely. They can, however, cause nausea. Whether or not you can continue with these injections will depend on your blood glucose levels and symptoms.
Is it safe for me to fast?

In general, fasting will carry more risks if you:

  • Have type 1 (as apposed to type 2) diabetes
  • Have had diabetes for more than 10 years
  • Take insulin injections or tablets such as gliclazide or glibenclamide (these drugs are known as sulphonylureas)
  • Have regular hypoglycaemia (low glucose levels)
  • Have poor glucose control
  • Do not perform glucose monitoring
  • Previously had experienced short term complications like Diabetes Ketoacidosis
  • Have diabetes chronic complications like eye, feet and kidney problems)
  • Are Pregnant
  • Are frail or have memory problems
  • Have a highly intense physical occupation
  • Are fasting more than 16 hrs

If you are unsure whether it is safe to fast during Ramadan, talk to your doctor who can help you to understand your risk.

Sulphonylureas

Sulphonylureas (e.g. gliclazide, glibenclamide, glimepiride, Dimicron MR): If you take sulphonylurea tablets or prandial glucose regulators (repaglinide, metaglinide, nateglinide), be aware that these can cause low glucose (hypoglycaemia) when you are fasting, which could make you feel ill. It is likely that your Suhoor dose may be reduced but the same dose can be taken at Iftar. The older drugs e.g glibenclamide should be avoided. Do talk to your doctor for specific treatment adjustment advice for you.

Acarbose

Acarbose: If you take acarbose and you feel unwell while you are fasting, you can consider reducing the dose or changing the timing of when you take them. If you continue to take them, the largest dose should be taken at Iftar, so that they work when you are eating.

Metformin

Metformin tablets, on their own will not cause low glucose (hypoglycaemia). But if you feel unwell while you are fasting, you can consider reducing the dose or changing the timing of when you take them. The largest dose should be taken at Iftar, so that they work when you are eating.

Professor Wasim Hanif MBBS MD FRCP

Prof. Wasim Hanif is a Professor of Diabetes & Endocrinology, Consultant Physician, & Head of Service in diabetes at University Hospital Birmingham. He is a Hon. Professor of Medicine at University of Warwick. He is the Board Member of Centre for Diabetes Endocrine & Metabolism, University of Birmingham. He is a visiting Professor at Birmingham City University and Medical Director of Advanced Diabetes Course. He is on the Board of Governors as a Trustee of Diabetes UK and  Non-executive Director of BMJ on its Board.

He is an eminent authority on Diabetes, Obesity, and Ethnic health. He works with several national bodies, and professional groups in the UK. He has been involved with major research projects in diabetes and has published widely.  He was selected for Kings Fund Leadership Program. His research interest includes diabetic kidney disease, diabetes prevention, cardiovascular disease in diabetes, diabetes in Ramadan, obesity, ethnicity and tackling health inequalities. He is well known authority on real world evidence working on big data with a dedicated bioinformatics team. He is involved as a chief and principal investigator in several international multi-centre trials and was instrumental in setting up UKADS (United Kingdom Asian Diabetes Study).

Prof. Hanif has been involved at a parliamentary level to advise the government on issues relating to Diabetes and ethnic health. He is the Chair of the Diabetes Working Group and Trustee of the world-recognised South Asian Health Foundation (SAHF).

He is a member European policy forum on diabetes advising EU. His involvement in NICE has been extensive, sitting on advisory NICE Health Technology Appraisal Committee between 2009 and 2015. He is on the Expert Advisory Committee of Commission of Human Medicine, advising MHRA on new Medicinal agents.

He is involved in several international projects, IDF WHO Global Policy Forum on Diabetes, Strategy for Commonwealth to guide ministers at UN summit, Chair International advisory board for ORNATE project India of MRC, member of UK Foreign & commonwealth office Scientific trade delegation among others. He is recipient of several national and international awards including the prestigious South Asian Health Foundation UK Lifetime Achievement Award.

 

Dr Mohamed Hassanein

Dr Hassanein is a senior consultant in Endocrinology and Diabetes at Dubai Hospital, Dubai, UAE since 2014. He holds Academic posts as H Professor of Medicine, Gulf Medical University, UAE, Adjunct Professor of Medicine, Mohamed Bin-Rashid University, UAE, as well as Associate Director for Postgraduate Diabetes Education, Cardiff University, UK since 2007. He was appointed to the post of Consultant in the Department of Endocrinology and Diabetes at BCUHB, UK, in 2002. Dr Hassanein graduated from the Faculty of Medicine, Alexandria, Egypt.

His main research interest is in the field of diabetes and Ramadan. He co-authored recommendations papers on this subject for the American Diabetes Association (ADA) in 2005 and 2010, and for the British Medical Journal in 2010, Diabetes Canada in 2017 as well as the IDF-DAR practical guidelines, 2016 and 2021. Dr Hassanein has participated as the first author and/or a co-author in numerous studies. He has published over 85 papers. He’s also the associate editor of DRCP as well as Dubai Diabetes and Endocrinology Journal.

Tracey Flax

Tracey Flax is a learning technologist with MyWay Digital Health. Her work focuses on developing structured education and resources for people with diabetes.  She has a keen interest in the intersection of health, tech and social equity.

Dr Nader Lessan

Dr Nader Lessan is a Consultant Endocrinologist at Imperial College London Diabetes Centre, Abu Dhabi, UAE, and an Honorary Senior Lecturer, Imperial College London. He had his undergraduate medical training at Newcastle University, and completed his clinical training in Diabetes, Endocrinology and General Medicine in the UK.

He is the Founder & Director for the Imperial Diabetes Educator Training (IDET) programme.

Assoc Prof. Dr Lee-Ling Lim

Dr. Lee-Ling Lim is Consultant Endocrinologist and Head of the Diabetes Care Unit, University of Malay Medical Centre, Kuala Lumpur, Malaysia. She is a member of the Scientific Work Groups of The Lancet Commission on Diabetes and the ADA/EASD Precision Medicine in Diabetes Initiative, who provide authoritative resources in tackling the global diabetes epidemic.

Dr. Lim has received several awards including the AOCO Rising Star Award, the USA Endocrine Society Outstanding Abstract Award, and the EFSD Albert Renold Fellowship. She has a keen interest in medical education and actively promotes health awareness by delivering medical lectures and public health talks at national and international levels.

Dr Barakatun-Nisak

Nisak is an Associate Professor and currently holds a position as a Deputy Dean Academic (Health Sciences) and Students’ Affairs, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM). She is also a practising dietitian in Diabetes Nutrition and Metabolic Obesity in HPUPM, a teaching hospital of UPM.

She is committed to improving metabolic control and quality of life in people with diabetes through proper medical nutrition therapy.

Salma Mehar

Salma is a Consultant Dietitian working in the field of community health and wellbeing for over 20 years. Salma is interested in delivering diabetes care through digital platforms and is currently supporting the Northwest London Diabetes Transformation programme.

She is also the co-author of the Carbs and Cals World Food Book. The first visual carbohydrate awareness resource for the BAME communities.

Dr Debbie Wake

Debbie is the CEO and Clinical Lead for MyWay Digital Health, and a Consultant Diabetologist working in NHS Lothian. Debbie also works at the University of Edinburgh as a Clinical Reader in Medical Informatics and Diabetes Care & Education.

She is passionate about improving the lives of people with diabetes through education and data driven care.

Bazaar Ramadan

In certain regions, Ramadan comes with food Bazaars – an annual gathering of food stalls which offer a variety of local scrumptious and mouth-watering delicacies for iftar. The variety of affordable and delicious food may cause overspending and overeating which, in the end, can lead to uncontrolled blood glucose and weight gain. Here are 4 tips to remember when you go to a Ramadan Bazaar:

  1. Plan your meal before visiting the Bazaar. If you are very hungry, you may make the wrong choice and buy unnecessary foods.
  2. Take time to identify healthier foods. Take a stroll along the aisles of the bazaar and make your decision at the end. By doing this, you will  make better choices of foods while walking, which is good for your health.
  3. Be careful of carbohydrate-rich food including sweetened beverages that are commonly available in the Bazaar.
  4. Stay within your budget and share your meals
Things to avoid during Ramadan
  • Eating particularly large meals at iftar (consuming more than 1500 calories per meal), which may result in high blood glucose levels after eating and weight gain.

  • Eating significant amounts of highly processed carbohydrates (Bagels, panini) and sugar at iftar, or between iftar and suhoor, which may also cause severe hyperglycaemia.

  • Eating desserts loaded with sugar after iftar, which can lead to raised blood glucose levels after meals.

  • Having large and frequent snacks between the two main meals, which can contribute to longer periods of high glucose levels.

  • Eating at a fast speed, which frequently leads to over-eating.

  • Eating suhoor early, which may result in feeling hungry before iftar, especially when fasting hours are longer than usual.

  • Consumption of large portions of high glycaemic index (GI) carbohydrates at suhoor, which can lead to high blood glucose levels after meals.

  • Frying food, which is particularly unhealthy, whereas many people choose to prepare snacks in the oven, bake or grill to keep food healthy and have less calories.

Ramadan fasting with existing conditions

Intermediate and long-acting insulin

Intermediate and long-acting insulins are often used on their own or in combination with quick-acting insulins. The dose of long-acting insulin may need to be reduced if you are fasting.

 

Fatima Ismail

Fatima Ismail, MS-Pediatric Diabetes Dietitian.

Fatima has completed her master’s degree in Diabetes Care and Management at Dundee University (UK) and graduated from Qatar University for her Nutrition undergraduate studies.

Fatima has more than 10 years’ experience in diabetes management, she is skilled in diabetes education and clinical research.

Her mission is to continually support people with diabetes to improve their diabetes by providing evidence-based dietary care.

 

 

Dr Mohamed Suliman

 

  • Graduated from the University of Khartoum, Sudan, and trained in general medicine, diabetes and endocrinology in the UK to obtain the certificate of completion of specialist training in diabetes and endocrinology.
  • Did endocrinology research which culminated in achieving a doctorate of medicine from the university of Sheffield, UK.
  • Worked as a consultant endocrinologist in the UK from 2001 to 2012 before joining the Imperial college London diabetes centre in Al Ain, UAE as a consultant endocrinologist from 2012.
  • Currently the lead doctor for medical guidelines at Imperial College London Diabetes Centre, Abu Dhabi and Al Ain, UAE.

 

Nina Patel

Nurse Consultant North West London

 

Dr Mohammed Iqbal

Dr Mohammed Iqbal is a Consultant endocrinologist and Bariatric physician in ICLDC Al Ain and Abu Dhabi. Special interest in T2DM management and management of Obesity and medical education. I am also an adjunct Senior Clinical lecturer in Endocrinology in Khalifa University in Abu Dhabi.

 

Ms Sahar Murad

Ms Sahar Murad, Senior DAFNE educator, DAFNE Certified. Experienced in pumps, technology in type 1 and follow up of all type 1 patients fasting in Ramadan.

 

Ms Etab Tagadom

Ms Etab Tagadom is a Senior DAFNE Educator, DAFNE certified. Has more than 15 years experience in type 1, type 2 and research. Was instrumental in DAFNE Ramadan workshop, and DAFNE Ramadan research and has presented widely nationally and regionally.

 

Ms Jumana Al Kandari

Ms Jumana Al Kandari, Head of DAFNE Unit, Senior clinical dietician with expertise in Type 1. Has been awarded her master degree from UCL.  Has extensive experience in the past 10 years in Ramadan fasting and Type 1 and established specific DAFNE Ramadan workshop.

 

Dr Ebaa Al Ozairi

Dr Ebaa Al Ozairi
BMSc(hons), MBChB, MRCP(UK), CCT(UK), FACN
American Board Of Physician Nutrition Specialist

Chief Medical Officer-­‐ Dasman Diabetes Institute Consultant Diabetes, Endocrinology and Nutrition
Former Fulbright Scholar-Harvard Medical School

Dr Ebaa Al Ozairi is the Chief Medical Officer at Dasman Diabetes Institute, a consultant Diabetes, Endocrine and Nutrition. Dr Al Ozairi has completed her intercalated BMSc (hons) in molecular pathology at Dundee University (UK) and graduated from Aberdeen University (UK) for her medical undergraduate studies. Ebaa then joined Newcastle University (UK) for her specialist training in Diabetes and Endocrinology. During her postgraduate studies in UK, Dr Al Ozairi was awarded The Fulbright fellowship to Joslin Diabetes Institute, affiliates of Harvard medical school, Boston, USA.

Her research interest includes Nutrition, Obesity, Diabetes, Education, Technology  and  Metabolic Surgery.

Dr Ebaa Al Ozairi has completed her fellowship in obesity and holds the American Board for Physician Nutrition Specialist and is a fellow at the American College of Nutrition. She  also  directs  DAFNE  type  1  diabetes education program and currently granted the training center for the  Middle  East.  Dr Al Ozairi has completed her Rabkin Fellowship in medical Education at Harvard Medical school. She is a reviewer for Lancet Endocrinology, European Journal for Endocrinology, Diabetic Medicine, Obesity, Surgery and Clinical Endocrinology.

Dr. Al Ozairi has 4 chapters in International books and an  author  in  Medscape,  bariatric times and Endodiabology and has more than 55 peer reviewed publications, in addition to more than 120 oral presentations in regional and international conferences. Dr Alozairi has won his highness the  Amir  Gold  medal  electronic  award  and  the  Arab  regional  award  for  e-­‐technology  for  co-­‐ founding the most comprehensive Arabic Diabetes Website. She was the 1st woman to become the president of American Association of Clinical Endocrinologist – Gulf Chapter.

Dr. Nagi Mohammed

 

Dr. Nagi Mohammed (Diabetologist) has acquired over 18 years of experience treating diabetes and endocrine conditions in a number of leading hospitals and medical centres in the UK and the Gulf region. He joined Imperial College London Diabetes Centre (UAE) since 2012

He has a special interest and extensive experience in Type 1 diabetes, insulin pump therapy and other diabetes technology.

In 2015, he became the founder and clinical lead of the insulin pump clinic for adults at Imperial College London Diabetes Centre in Al Ain.

A passion for medical education has seen Dr. Nagi mentoring fellows in the Diabetes and Endocrinology fellowship program at Imperial College London Diabetes Centre since 2015, while also teaching at ICLDC’s Diabetes Educator course.

Aside from clinical work and teaching, Dr. Nagi has been actively engaged in research. Amongst other things, his research interests include Type 1 diabetes , Bariatric surgery and Diabetes in Ramadan .

Dr Luqman Ibrahim

Dr Luqman is an endocrinologist whose main area of work is improving diabetes care delivery, including during Ramadan and during the COVID19 pandemic, for people with type 1 and type 2 diabetes. He is currently involved in establishing the Diabetes Care Unit in Regency Specialist Hospital in Johor Bahru.

Tips for managing hypoglycaemia
  • Always carry glucose treatment with you.
  • Test your blood regularly to monitor your glucose levels. This will not break your fast.
  • Test your blood glucose level if you feel unwell during the fast.
  • If your blood glucose level is high or low, you must treat this.
  • If your blood glucose is less than 4 mmol/L (72 mg/dL), end the fast immediately and treat the low blood sugar level.
  • If your blood glucose level is 4 mmol/ L (72 mg/dL) at the start of the fast and you are on insulin or gliclazide, do not fast.
  • If your blood glucose level is higher than 16mmol/L (288 mg/dL), end the fast immediately.
  • If you become dehydrated, end the fast immediately and have a drink of water.
  • If you start to feel unwell, disoriented, confused, if you collapse or faint, stop fasting and have a drink of water or other fluid.

 

Symptoms of Hypoglycaemia

• Sweating
• Trembling and Shaking
• Hunger
• Going pale
• Heart palpitations
• Irritability
• Feeling dizzy

 

Frequency of testing blood glucose

 

  • Type 1 diabetes: at least 5 times per day (more often if using flash/continuous glucose monitoring)
  • Type 2 diabetes on insulin: 2-5 times per day (depending on risk)
  • Type 2 diabetes not requiring insulin: frequency of testing depends on the type of therapy, risk of hypoglycaemia or hyperglycaemia, level of glycaemic control and duration of fast
Pre-mixed insulin

Pre-mixed insulins are not usually recommended during periods of fasting. If you do continue to use these insulins, it is likely that you will have to adjust the timing and doses so that you are always taking your insulin in conjunction with eating.

You will need to discuss any changes to your insulin regime with your diabetes care team, so be sure to contact them for advice well in advance of the next Ramadan.

Quick-acting insulin

Quick-acting insulins (such as novorapid, humalog,  f-iasp) are usually taken at the time of eating and the dose can be adjusted according to the food intake or to correct a high glucose level.  These provide a more flexible insulin regime, making it easier to alter the doses and change the timings of your injections. Your diabetes care team may advise you to change to quick-acting insulin so that you inject only when you are eating. These are usually taken in combination with long-acting insulin.

For more information on insulin adjustment at mealtimes:  Carbohydrate Counting

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