During the holy month of Ramadan, people across the globe observe the spiritual practice of abstaining from food and water from dawn till dusk.
Fasting can be a beneficial practice for healthy people, but may be risky for people with diabetes. So if you have diabetes, and have been fasting without consulting your doctor, you should get in touch with him or her immediately.
A general rule about fasting cannot be applied to all people with diabetes as the condition of each person varies depending on multiple factors: the type of diabetes, the stage of progression of the condition, the level of blood sugar fluctuations, and medication.
For example, people who tend to have very high or very low blood glucose levels are not advised to fast. Similarly, patients with type 1 diabetes who have unstable disease with co-morbid conditions are also advised against fasting.
Dr Rachna Kucheria, Chief-Operations and Medical Director, Diabetacare, said, "Your decision on whether to continue with fasting or refrain from it should depend completely on your doctor's medical advice. If you are not fit enough to fast, your doctor will explain to you in detail the potential risks of fasting. On the other hand, if they believe your condition allows you to continue the fast, they would advise you to change your medication, adjust the levels of insulin to meet the body's requirements during fast and recommend dietary changes and activity patterns you must follow during non-fasting hours."
A wide scale epidemiological study conducted across 13 Islamic countries and published in Diabetes Care Journal in 2004 provided rough prevalence estimates of fasting among diabetic patients in these countries.
The study estimated that around 43 percent of type 1 diabetes and 86 percent of type 2 diabetes patients fasted during Ramadan. Covering 12,243 individuals with diabetes who fasted during Ramadan, the study found that while the overall incidence of hypoglycemic events (falling blood sugar levels) was low, severe hypoglycemia instances were more frequent during Ramadan, indicating a higher link between fasting and hypoglycemia.
Points to Remember:
• See your doctor. Adhere to his/her advice.
• The doctor may recommend a dosage adjustment, to meet the requirements of the fast
• Many people believe that checking the blood glucose levels will invalidate their fast since it involves pricking your finger to ooze out blood. However, there is consensus among Islamic scholars that checking blood glucose doesn't break your fast. It is important practice during fasting to check your blood glucose levels more often to prevent serious complications occurring.
• Do not hesitate from breaking the fast the moment you find imbalance in your blood sugar levels or experience symptoms like dizziness.
• Consume a meal comprising whole grain, protein and moderate fat during the pre-dawn meal so that it is digested slowly during the fasting hours. Have food such as basmati rice and dal, which are good sources of energy. At the same time, do not overeat while breaking the fast and avoid only eating sweets or deep fried foods. This may result in hyperglycemia, or a rise in sugar levels above the 'normal' range.
• Drink plenty of water during the non-fasting hours from dusk to dawn and avoid caffeinated drinks that can lead to dehydration. Dehydration can lead to a rise in blood sugar levels as well.