Fasting during the holy month of Ramadan is a religious obligation followed by Muslims worldwide. This religious obligation is considered among the five basic pillars of the religion Islam.
Depending upon which month Ramadan falls, fasting periods can last up to 22 hours in some countries. Muslims have to abstain from eating or drinking anything (including water) during daylight hours (dawn to sunset) and eat only two meals per day.
There are approximately 19 million Muslims in Pakistan that are living with diabetes. It is quite common for them to find it difficult to know how to manage their diabetes during fasting in the month of Ramadan.
If you are a diabetic patient and worrying about managing your diabetes while fasting, then fret not.
Our article on Ramadan: risks, diet, and everything in between for diabetic patients will provide you with all the essential tips, guidelines, and assistance for a safe Ramadan with diabetes.
So without further ado, let’s get started.
Preparing for Ramadan
To prepare for Ramadan, it is recommended to consult your general physician or endocrinologist two months before the start of Ramadan.
To have a safer Ramadan, you need to consider the following:
- You will fast this year.
- Your diabetic medication or doses be changed
- You will make some changes to your food choices.
- Physical activity will affect your diabetes during Ramadan.
Diabetes Medications
It is important to remember that using Insulin does not break your fast during Ramadan.
You should also ensure to consult your endocrinologist before the start of Ramadan. This is essential because your diabetes medication may need to be changed to reduce the risk of blood sugar levels getting too low or high.
Type 2 Diabetes patients may be instructed by their doctors to stop using Insulin during Ramadan. This will be done to prevent the risk of hypoglycemia. However, Type 1 Diabetes patients should continue using Insulin.
Make sure to use diabetic medications in Ramadan that is developed only by one of the leading pharmaceutical companies In Pakistan. This is crucial because only with the best quality medication, diabetic patients can guarantee safe fasting.
Diet
With daily calories intake split between two meals (Suhoor and Iftar) per day, you need to maintain a balanced diet during Ramadan.
There’s no need to make any drastic changes in your diet for Ramadan. It should be similar to what it will be for the rest of the year.
Most of the time, the type and amount of food intake change during Ramadan. This can have various effects on your blood sugar levels and weight. Selecting the diet that has the minimum effect on your blood sugar level and weight should be your priority.
Here are some top diet tips for diabetic patients during Ramadan:
- Avoid drinks that contain sugar, grains, and caffeine.
- Drink plenty of water and non-sweetened beverages to stay hydrated, particularly at the start of Iftar.
- Take 1-2 dried or fresh dates at Iftar to safely raise blood glucose levels.
While a balanced diet is essential for Diabetics patients during Ramadan to keep their blood sugar level maintained, some medications can help them achieve this purpose.
Medicines such as Duvel Plus, created only by the top pharmaceutical companies in Pakistan can assist diabetes patient control their blood sugar levels during Ramadan.
Risks
Now, let’s talk about some risks faced by diabetic patients during Ramadan. Here are some of the most common risks that can occur during Ramadan:
- Hypoglycemia (low blood glucose levels)
- Hyperglycemia (high blood glucose levels)
- Severe hyperglycemia (e.g. Diabetic Ketoacidosis)
- Dehydration
Physical Activities
Whether you are active or inactive will also affect your blood sugar levels and weight.
While fasting, physical activity can expose you to the risk of hypos, especially if you are on treatment with insulin, dehydration, or Sulphonylureas (e.g. Gliclazide).
Light to moderate exercise is encouraged during Ramadan but excessive or strenuous exercise should be avoided at all costs. However, the ‘Taraweeh’ (night prayer) can be part of your physical activity regime.
Top Tips:
- You should monitor your blood sugar levels during exercise regularly.
- Carry water and hypo treatment during exercise (e.g. Glucose tablets 4-5).
- Try being physically active after eating.
Breaking the fast
It is recommended to break your fast immediately if you experience any of the following:
- Blood glucose level below 4.0 mmol/L.
- Blood glucose level above 16.6 mmol/L.
- Symptoms of hypoglycemia, hyperglycemia, dehydration, or acute illness.
In the wake of the broken fast, drink plenty of non-sugary, caffeine-free drinks, and consult your endocrinologist or general physician.
Smoking
Any form of smoking such as vaping, shisha, or tobacco consumption is prohibited during fasting during Ramadan.
Smoking increases the risk of heart diseases in diabetic patients. Consider Ramadan as a perfect opportunity to give up smoking.
Exemptions to fasting
If certain conditions are met, diabetic patients may not be required to fast during Ramadan. These conditions include:
- Using diabetes medication.
- Living with diabetes-related complications such as eye, kidney, or nerve problems.
- Have an HbA1c (average glucose level over 12 weeks) that is out of your target range.
If you have any of the following health conditions or circumstances, you are also not required to fast:
- Under the age of puberty.
- Elderly or weak.
- Unwell or living with a mental health condition.
- Living with learning difficulties.
- Traveling long distances.
- Pregnant, breastfeeding, or menstruating.
Post Ramadan Advice
Muslims celebrate Eid ul-Fitr – a 3-day festival to mark the end of Ramadan. Please be aware of the risk that overindulgence has in causing hyperglycemia.
Just like you consult your general physician or endocrinologist before the start of Ramadan, it’s time to do the same once Ramadan has finished for the following reasons:
- Diabetic medication and diet readjustments.
- Discussion related to your health and wellbeing during the fasting period.
- Develop an action plan for you to cope better with future fasts.
Always remember to consult a professional general physician or endocrinologist two months before Ramadan.
