Approximate number of Muslims with diabetes is around 4.6%; it is estimated that there are about 50 million Muslims with diabetes around the world who observe fasting during the month of Ramadan each year. During the fast, Muslims are required to refrain from eating food, drinking, using medications, and smoking from dawn until sunset, with no restrictions on food or fluid intake between sunset and dawn.
Islam exempts people from the duty of fasting if they are sick, or if fasting may affect their health, as fasting for patients with diabetes carries a risk of an assortment of complications, including hypoglycemia, postprandial hyperglycemia, and metabolic complications, associated with dehydration. Nevertheless, a large number of people with diabetes who still choose to fast during Ramadan despite the advice of their doctor, and the permission received from religious authorities thus create medical challenges for themselves and their health-care providers.
It is thus important for patients with diabetes who wish to fast during Ramadan to make the necessary preparations to engage in fasting as safely as possible, said Consultant Endocrinologist, Shifa International Hospital (SIH) Dr. Osama Ishtiaq in a seminar “Roza aur Sehat” organized by Shifa International Hospital to create awareness in diabetic patients intended to observe fasting without harming their blood glucose level.
Dr. Osama said that Fasting is very challenging for people living with diabetes, particularly patients with type 1 diabetes, who are dependent on insulin. Muslims with diabetes who wish to fast must plan diligently for a safe and healthy Ramadan. It is important to individualize each patient’s management plan depending on his or her diet and lifestyle, medications, risk of hypoglycemia, and glycemic control, and to minimize the complications associated with fasting.
Continue taking your diabetes medicine as per advice of your doctor regarding dosage and timings.
“Control your Diabetes for two months prior to Ramadan bringing HbA1c to less than 8 and continue Diabetic diet in Iftaar and Sahur,” Dr. Osama added.
Ms. Zainab Ghayyur, Senior Clinical Dietitian (SIH) advised the patients to monitor their blood glucose regularly during the fast, especially in the early days. Overeating is a greatest risk.
Continue taking your diabetes medicine, regarding dosage and timings talk to your doctor. If you experience hypoglycemic symptoms, it is advisable to break the fast and make up for it after Ramadan.
She said that suhoor meal should contain a balance of whole grain sources of complex carbohydrates as well as some protein from lean sources of meat, fish and poultry, small amounts of heart healthy fats, limit added sugars this will slow the digestion and the feeling of fullness last as long as possible into the day. Also include fresh fruits, vegetables, and yoghurt in your meals. Limit the dates (khajoor) to two or three pieces. Avoid exercise during the day, and take rest when possible to help avoid lowering of blood glucose levels. Limit physical activity during fasting hours and be more active after sunset,” she suggested.
Mr. Azmatullah Quraishi, Head of Religious Affairs (SIH) highlighted the importance of fasting in Islam and its positive and spiritual impacts. He said that there was no excuse for skipping fasting in minor diseases like flu or fever. Those who are ill with no expectation of recovery, and those who are too old and are not able to fast. Some health practices that do not affect fast such as use of injection (except nutritional injection), using asthmatic inhaler and donating blood, vomiting, and pouring medicines into the eyes or ears, he concluded.
