Fit to fast
Diabetics need to assess whether they can fast and also ensure they eat proper and balanced meals to avoid risks, writes Kasmiah Mustapha
EVERY Ramadan, the focus is on people with diabetes. The common questions are whether they should fast, is it safe for them to do so, and what the risks are if they do. Diabetics face the most challenges in managing their disease during the fasting month.
National Heart Institute (IJN) deputy manager dietetics and food services Siti Farhath Sehu Allavuddin says this is because their blood sugar level changes immediately, especially during sahur (predawn meal) and iftar (breaking of fast). They also need to make adjustments with regard to their medication.
For sahur, they are either not eating at all or not eating enough which can lead to hypoglycaemia, or low blood sugar level. On normal days, when this happens, they can quickly eat something but they cannot do that during Ramadan.
Unfortunately, some refuse to break their fast when they are faced with symptoms of hypoglycaemia, especially if it is close to iftar. But what they don’t realise is that they can collapse and it can lead to organ damage and maybe coma, says Siti Farhath.
“On the other hand, diabetics tend to eat too much during iftar and will continue after tarawih prayers. So it is the non-stop eating which leads to high blood sugar level or hyperglycaemia.
“Surprisingly, many people with diabetes think they can fast when their blood sugar level is high because they feel they can overcome the symptoms. Actually they are putting themselves in danger, because the symptoms are similar to hypoglycaemia.”
Diabetics are also at risk of dehydra-
It is about balanced meals, so avoid salty food, sweet drinks and high carbohydrates. Siti Farhath Sehu Allavuddin
tion as a result of inadequate fluid intake between iftar and sahur.
Siti Farhath says while it is expected that Muslims perform the third pillar of Islam, they need to assess whether they are fit to fast and make sure they eat proper and balanced meals to avoid risks.
Most importantly, they need to check their blood sugar level immediately when they have symptoms of hypoglycaemia or hyperglycaemia. When the reading is less than 3.3 mmol/L or more than 16.7 mmol/L, they have to break fast.
If diabetics want to fast, it is important not to skip sahur. They should have their meals at least 20 minutes before imsak (10 minutes before dawn) and it should consist of balanced nutrients.
“Diabetics can have fried rice with vegetables, chicken and eggs, with fruit and water. Avoid coffee and don’t just eat dates for sahur.
“They should also never delay iftar but limit food intake. Again, it is about balanced meals, so avoid salty food, sweet drinks and high carbohydrates. Any food that is a source of carbohydrates such as dates, apples, oranges and bananas will have an
IJN dietetics and food services senior manager Mary Easaw shows how to prepare bubur lambuk for diabetics; (From left) Loo and Siti Farhath with the Nutren Untuk Diabetik Diabetes Management Guide & Simply Delicious Ramadan Recipes booklet. impact on blood sugar reading. You can eat them but not too much.”
Those who are at higher risk are people with a history of severe diabetes complication within three months prior to fasting, hypoglycaemia unawareness, type 1 diabetes, poor glycaemic control, those who perform intense physical labour, pregnant women and those who suffer from advanced kidney failure.
IJN and Nestle Health Science have jointly launched the Nutren Untuk Diabetik Diabetes Management Guide & Simply Delicious Ramadan Recipes booklet to support diabetics to manage their disease while fasting.
It contains details on risk categories for people with diabetes, physical activities that diabetics can do, how to control their diet and suggested meals for sahur and iftar. There are also healthy recipes that diabetics can follow.
Nestle Health Science business executive officer Emilyn Loo says it has been Nestle’s aim to support people with diabetes lead healthier lives. Working together with dietitians from IJN to provide innovative and complete nutritional supplements for people with diabetes echoes the commitment.
“Contrary to popular belief, fasting is safe for the majority of people living with type 2 diabetes. However, there are potential health challenges if you are in the high risk category. We hope to bring to light to these issues and offer solutions for diabetics through this booklet,” says Loo.