People with diabetes have high risk of developing fasting-related complications during Ramzan. Although doctors advise against fasting and feasting for diabetics, some people insist on doing it. The best way to do this is by getting medically assessed before the the fasting month.

The American Diabetes Association recommendations for management of diabetes during Ramzan state that it is important to seek medical advice and undergo a pre-Ramzan assessment. Doctors advise that type 1 diabetics (insulin-dependent) should not fast.

City-based endocrinologists say changes in eating patterns experienced during Ramazan can put people with type 2 diabetes (those who have insulin resistance) at the risk of complications such as low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), diabetic ketoacidosis, thrombosis and dehydration. Endocrinologist Mala Dharmalingam says the risk of hypoglycemia in type 2 diabetics who fast is because of decreased food intake apart from certain medications. Symptoms of hypoglycaemia include sweating, dizziness, hunger and irritability.

“If left untreated, hypoglycaemia could lead to serious medical problems including loss of consciousness, convulsions or seizures,” she adds.

Punam Bhende, consultant Diabetologist at the State-run Karnataka Institute of Diabetology (KID), says type 2 diabetics should monitor their blood sugar frequently during Ramzan. “Tailored management of diabetes including treatment changes could help minimise the risks associated with fasting,” Dr. Bhende says.

Vasavi Shabrish, Nutritionist and Diabetes Educator at KID, says diabetics on fast could get dehydration or excessive loss of body fluid because of limited fluid intake.

“It is important to know what to eat if you are a diabetic and are fasting. It is advisable to eat chapatti, ragi balls and cereal-based combinations during sehri. Apart from taking care to have a balanced meal and not straying away from the diabetic diet, the iftar should be split into two snacks and a meal. While breaking the fast, dates should be replaced by fruits. Non-vegetarian food and oily/fried food should be avoided,” she adds.