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Precautions for diabetic patients while fasting

DUBAI — Most religious authorities consider diabetes among chronic diseases and exempt such from fasting.

However, many individuals wish to fast during Ramadan, therefore, they need to be aware of the associated risks and be ready to adhere to the recommendations of their healthcare providers to achieve a safer fasting experience, said Manal Al Buflasa, Senior Nurse Educator, Dubai Diabetes Centre, DHA.

Decreased food and fluid intake during Ramadan can cause severe Hypoglycemia (hospitalisation due to decrease blood glucose level), severe Hyperglycemia (hospitalisation due to increased blood glucose level), Diabetes Ketoacidosis (usually occurs in Type 1 patient due to excessive reduction of insulin dosages), and dehydration (caused by prolonged fasting hours as well as the hot and humid climate), she explained.

People with diabetes who are fasting should:

υ Frequently monitor blood glucose: in the morning, noon, 4pm, before breaking the fast, two hours after Iftar, 12 midnight (if possible) and before Suhoor. (especially type 1 patients and type 2 patients who are on insulin).

υ Suhoor meal should be taken as late as possible before the start of the daily fast.

υ For Suhoor, it is advisable to have complex carbohydrates, while foods with more simple carbohydrates will be more appropriate at Iftar.

υ Increase the fluid intake during non-fasting hours.

υ Avoid excessive physical activity, especially a few hours before Iftar meal, which may lead to low blood glucose.

υ Tarawi prayers (multiple prayers after the sunset meal) should be considered a part of the exercise programme.

υ Fasting should be broken if blood glucose levels reach over 300 mg/dl, to avoid severe Hyperglycemia and Dehydration (patients will have to drink plenty of water).

υ Fasting should be broken immediately if blood glucose is less than 60mg/dl any time since it is not guaranteed that the blood glucose will not drop further if treatment is delayed, or if blood glucose is less than 70mg/dl during the first few hours after the start of the fast specially if one of the insulin secretagogues were used at Suhoor

υ Patient should avoid fasting during sick days.

“All patients with diabetes who wish to fast during Ramadan should undergo the necessary preparations,” said Manal. — news@khaleejtimes.com