Diabetics must be cautious during Ramadan fasting: experts

Fasting during Ramadan, the ninth month of the Muslim year, is a personal choice for diabetes patients and should be done only under medical supervision, according to doctors.
Experts recommend a diabetes assessment during Ramadan which would make patients aware of risks, based on which they could be advised to minimise the risks.
"Fasting during Ramadan requires a person to take two meals a day with long gaps in between. Modifying consumption patterns leads to changes in body metabolism and diabetics should adjust their treatment plan accordingly," says Dr Shehla Shaikh of Mumbai's KGN Diabetes & Endocrinology Centre.
Diabetics should avoid consuming highly refined and fatty foods after breaking the fast and if there are any signs of hypoglycemia (deficiency of glucose in the bloodstream), they should discontinue the fast, she recommends.

Hypoglycemia could arise among fasting diabetics which may cause seizures and unconsciousness. The other problems a patient may face include hyperglycemia or an inordinate increase in blood sugar levels; Diabetic Ketoacidosis, a potentially life-threatening complication that can cause vomiting, dehydration, deep gasping breathing, confusion and coma; and thrombosis that leads to formation of clots inside the blood vessels, according to doctors.
Patients with type 1 diabetes who have a history of recurrent hypoglycemia are at a higher risk if they fast, according to experts.

Hypoglycemia or hyperglycemia may also occur in patients with type 2 diabetes but is generally less frequent and with less severe consequences as compared to patients with type 1 diabetes, they say.

To avoid complications during fasting, doctors advise a diet of carbohydrates for diabetics and recommend them to break their fast immediately, if any warning signs occur.
"Diabetes patients are advised to consume more of carbohydrates of high calorie. In addition to keeping the doctor informed, the patient and family members must be aware of any warning signs and should discontinue their fast if such symptoms manifest," said Dr K D Modi, endocrinologist, Medwin Hospital-Hyderabad.
Since dehydration is a potential risk for a diabetic during day time, fluid intake during 'sehri' (early morning breakfast) should be liberal, says Dr Atul Luthra of Fortis hospital in New Delhi.

"Diabetics should eat more fresh fruits and green vegetables. Beverages containing caffeine and fried fatty foods should be avoided since they increase the risk of dehydration," he adds.