Within the holy month of Ramadan, Muslims world wide quick from daybreak to nightfall. Not solely do they abstain from food and drinks, but in addition from sure habits and behaviors.
Fasting is without doubt one of the 5 pillars of Islam, however the faith exempts these affected by persistent situations from fasting. Nonetheless, many individuals with diabetes nonetheless select to quick and doing so would possibly adversely have an effect on their well being. Mealtimes change and other people with diabetes, like everybody else, eat meals that’s excessive in saturated fats and sugars, like sweets and fried meals. Fasting through the day and feasting at night time results in huge fluctuations in blood glucose ranges that may turn into problematic. This has led diabetics to ask: “Can I quick this Ramzan?”
Earlier than we reply that query, we should know what occurs to diabetics whereas fasting.
This 12 months, Ramadan begins on the third of April and entails 13- 14 hours of fasting. Such a protracted hole between meals might result in metabolic modifications within the physique, triggering sure issues. Fluid restriction results in dehydration and blood glucose fluctuations, which may both be low or excessive. A fall in blood glucose degree, often called hypoglycemia, might trigger drowsiness, seizures, or unconsciousness. Excessive blood glucose degree, often called Hyperglycemia, may cause blurry imaginative and prescient, complications, elevated fatigue, and thirst. Collectively, hyperglycemia and dehydration can precipitate the formation of ketones (acids) within the blood resulting in a situation known as Diabetic Ketoacidosis (DKA), which causes stomach ache, vomiting, dehydration, confusion, and even coma. Dehydration itself might trigger thrombosis (blood clots) in individuals with uncontrolled diabetes.
So, who can or can not quick in Ramzan?
The Worldwide Diabetes Federation, by means of its Ramzan Working Group known as DAR (Diabetes and Ramzan) has issued tips on who can or can not quick. Al-Azhar College (Jamia Al-Azhar Shareef) of Egypt, the very best authority on spiritual edicts (fatwa) has ratified these tips. Diabetic sufferers wishing to quick in Ramadan are categorized into Low Threat, Reasonable Threat and Excessive Threat. Please go to DAR web site (https://daralliance.me) for detailed data and to obtain their fasting threat calculator. There may be additionally a helpful App for Android & iPhone obtainable on the web site.
Medical doctors advise individuals with diabetes at excessive threat for the situations talked about above to not quick. This consists of those that have had extreme hypoglycemia or DKA inside 30 days previous to Ramadan and people with Kind 1 Diabetes, or recurrent hypoglycemia. The aged and people with issues corresponding to persistent kidney illness (kidney failure) and people diabetics who’re pregnant and on insulin injections are additionally at excessive threat and should not quick.
Most individuals with kind 2 diabetes and no issues can quick as per medical recommendation, however they have to examine their blood glucose all through the day – Sehri time (pre-dawn meal), 12 Midday, 4 pm, Iftar time, 2 hours after Iftar, and after they really feel unwell.
Based on the Worldwide Diabetes Federation and the Jamia Al-Azhar Fatwa, diabetic sufferers are suggested to interrupt their quick in the event that they expertise: 1)Hypoglycemia: blood glucose falls beneath 70 mg/dL with or with out signs i.e. dizziness, starvation, irritability, confusion, and a quicker heartbeat, 2) Hyperglycemia: blood glucose rises above 300 mg/dL with or with out signs i.e. dry mouth, elevated urine and thirst, and three) presence of signs of acute sickness corresponding to fever, diarrhea, vomiting, and/or exhaustion. If this occurs seek the advice of your physician instantly.
Most anti-diabetes medicines and Insulin will want dose changes or a change in timing throughout Ramzan to quick safely. Sufferers should additionally take care to not cease insulin by themselves. Due to this fact, you will need to go to your physician previous to Ramzan for professional recommendation associated to meals & drugs.
Food regimen in Ramadan
Individuals with diabetes wishing to quick should incorporate a wholesome, balanced weight loss program throughout Ramadan. At Sehri time, embrace meals gadgets which have a low glycemic index and excessive fiber like brown rice, brown bread & greens. Eggs, dal, and meat nourish you with all-important protein and don’t elevate blood glucose. Bear in mind to remain hydrated. Keep away from caffeine, candy drinks & juices, desserts, and fried meals. Eat fewer dates as a result of they’re excessive in fructose, which is sweeter than glucose and this may elevate blood glucose ranges larger. Make sure that Iftar doesn’t turn into a feast.
Individuals with diabetes should not train whereas fasting. They could train after Iftar. Earlier than, throughout, and after their exercises, they have to preserve properly hydrated and examine their blood glucose to make sure it’s inside a suitable vary, often between 140 – 180 mg/dL.
Spirituality, religiosity and private beliefs are essential parts of the social determinants that have an effect on sufferers’ well being behaviors and adherence to therapies. But when accomplished proper, Ramadan is an efficient month for cleansing, controlling blood glucose & shedding pounds. So, profit from it.
Dr Najeeb is Division.a specialist doctor primarily based in Kuwait at JGH Endocrinology & Diabetes
