Ramzan, the holy month of prayer, introspection and fasting, is viewed as a way to cleanse the body and soul. All Muslims having reached puberty and in good health are required to fast. The only exceptions are the sick and the travellers. The fast is spread over a long period with the gap between meals ranging from 12 to 15 hours. It can pose a serious health problem for diabetes patients, as they require to have regular meals on time. It requires adjustment in the diabetes administration as it results in metabolic changes.
What is important for those wanting to fast is to consult a doctor a month in advance and follow the medical advice along with the prescribed diet and medication. Frequent monitoring of blood sugar levels throughout the day is a must for diabetic patients.
According to Dr. Vikas Ahluwalia, Director Diabetes and Obesity Centre, Max Super Specialty Hospital Saket, “If a diabetic patient wants to keep fast, it is necessary to take precautionary measures and better to consult their endocrinologist. One should take doctor’s approval and monitor the diet as well as medication to keep sugar level under control during this month. In case of any unusual change or uneasiness, one should immediately consult the doctor.”
He highlights some of the difficulties faced during fasting by the diabetic patients. These include immoderate increase in blood sugar levels (hypoglycemia) causing hazy vision, headache, increase in fatigue and thirst. Diabetic ketoacidosis is a potentially life threatening causing vomiting, dehydration and coma.
Dr. Ahluwalia suggests precautions for Type 1 and 2 diabetic patients. “Since patients are only on two meals a day and Type 1 diabetics take four shots of insulin each day, they should not take their lunch insulin to avoid hypoglycaemia. As these patients take three types of insulin, they should cut back on long acting insulin dose. As for Type 2 patients they should make sure to reduce the dose of oral tablet to half, especially the long acting oral drugs .”
Over the years, people with diabetes have undertaken fasting by following certain safeguards. One such is Farida Begum. “I am a patient with Type 2 diabetes so I generally fast during Ramzanwith certain precautions.
I usually take my medicine during sehri and then after iftar while regularly noting my sugar level. I take proper care of my food habits and avoid those items which may create problem for me.”
Prof. Saud Ali Khan, a Unani medicine expert, who is the Principal and Senior Medical Superintendent at Ajmal Khan Tibbiya College Aligarh Muslim University, says, “Patients with Type 1 diabetes are at a higher risk because they are more prone to hypoglycemia.
However, patients with Type 2 can fast but they should take care of glucose levels and regularly check their sugar along with proper diet and medication.”
Most diabetic patients who have a history of bouts of hypoglycemia avoid fasting during Ramadan. Rana Khatoon, another diabetic says, “I am suffering from diabetes since 12 years. Earlier I used to keep fast on alternate days. Now it’s difficult for me as I am suffering from Type 1 and need to be more conscious about it. Last time I faced serious problem of sudden fall in blood sugar level resulting in seizure and unconsciousness.”
The doctors also advise on the diet. Dr. Ahluwalia suggests consumption of starchy items like rice and wheat chappatis in moderation; avoiding deep fried foods such as parantha, puri, samosas and pakoras.
For right nutrition intake at sehri, he advises inclusion of whole grain bread, whole grain low sugar cereals, beans and lentils in the food. For breaking the fast, he suggestssugar free and decaffeinated fluids to avoid dehydration.
