Diabetes and Ramadan

Fasting is commonly associated with the month of Ramadan. Billions of Muslims around the world get engaged in this declaration of faith that involves abstaining from food and drink from dawn until dusk. A number of studies have suggested intermittent fasting has numerous health benefits including weight loss, lower blood pressure and reduced cholesterol.

Diabetic patients should consult the doctors before fasting in Ramadan, as repeated disturbances in diabetes control can result in permanent complications. Diabetic patients have the risk of low or high blood sugar, dehydration and sometimes acidosis (presence of increased acids in the blood). But not all patients have similar risks. Therefore it is recommended that all diabetic patients should consult their doctors and discuss their risks.

Diabetic patients should be evaluated before the month of Ramadan to assess their physical well-being, metabolic control and ability to fast. Diabetic education should include aspects such as home blood glucose monitoring, dietary principles, and any therapeutic adjustments that may be necessary.

If you choose to fast during Ramadan, it is important to establish a diabetes management plan one can follow to control blood sugar levels. It is important to understand what needs to be done to prepare for the fast, as well as how to control blood sugar levels throughout the month.

Home blood glucose monitoring is an important prerequisite in the management of diabetic patients who are treated with insulin. In this way, a close watch can be kept and adjustments to the insulin dose can be made as required.

Patients should also be aware about the warning symptoms of dehydration, hypoglycaemia and hyperglycaemia; the need to break their fast as soon as any complication occurs and the importance of seeking immediate medical help if they have concerns regarding the management of their diabetes.

During the fast, patients with type 2 diabetes understand that they are at an increased likelihood of developing hypoglycaemia or low blood sugar that occurs when the level of sugar in blood drops below normal levels. Long gaps between food intakes, along with certain diabetes medications, are risk factors for hypoglycaemia. Symptoms may include sweating, dizziness and irritability.

Dehydration can be caused by limited fluid intake. Symptoms of dehydration may include thirst, dry mouth, muscle cramps and heart palpitations. Hyperglycaemia or high blood sugar occurs when there is too much sugar in blood, and can be caused by an increase in food or sugar intake, or by an excessive reduction in dosages of diabetes medications. Symptoms may include weight loss, increased thirst and frequent urination.

We generally consume large quantities of fried and sugary foods when breaking fast or during the night. This can be a problem for the management of diabetic patients; their diet during the night could contribute to hyperglycaemic attacks.

Here are some simple diet tips to consider during Ramadan: At Sehri, try slow-release energy food such as brown bread, semolina and beans. At Iftar, consume fruits, followed by slow-acting carbohydrates such as brown rice, oats and vegetables. Avoid foods high in saturated fat, such as ghee and fried foods like samosas and singaras. Increase fluid intake during non-fasting hours and especially at Sehri and Iftar.

By thorough assessment and understanding between doctors, nutritionist and patients, it is possible to fast safely for people with diabetes.

The writer is a physician, public health specialist and a gerontologist. E-mail: zubairkhaledjoy@gmail.com