New research by the universities of Manchester and Keele shows that British Muslims with diabetes may avoid attending GP surgeries to discuss fasting during the holy month of Ramadan.

The research, the first of its kind in the UK, found many saw fasting during Ramadan as a religious duty which should be fulfilled in spite of having diabetes. Some avoided telling their GP or practice nurse they were fasting. While those who did reported that they were advised not to fast but went ahead anyway.

Some patients reported receiving pressure from their family to fast as well as guilt and embarrassment at not doing so. Others reported eating their daytime meals in secret or when other family were not in the house.

There are 3 million people in the UK with diagnosed diabetes, which is four times more common in the Bangladeshi and Pakistani groups than the general population. Recent figures suggest around 325,000 Muslims have diabetes in the country.

This year Ramadan will fall at the end of June and more daylight increases the number of fasting hours, posing difficulties for Muslim diabetics who need to eat and take medication regularly to maintain glycaemic control.

Neesha Patel of Manchester University and lead author of the report noted that "although the Islamic law states that the ‘sick’ can be exempt from fasting for one or all 30 days, the majority of Muslim respondents with diabetes do not perceive themselves as ‘sick’ and therefore choose to fast". She added that non-adherence to their treatment regimes "may result in more Muslim patients suffering the risks and complications associated with diabetes, leading to poor quality of life and increased use of NHS health services".

Carolyn Chew-Graham, a Manchester GP who worked with Dr Patel on the study, said the results show the importance of considering patient experiences, especially when forming guidelines in this area "and suggest a need for better training for GPs and practice nurses and with mosques and community leaders".