Health guidelines for diabetics during fasting
Diabetics in Oman must get checked regularly during the Holy Month of Ramadan, says Dr A Basheer, a senior internist and diabetologist at Badr Al Samaa Hospital.
“There are reasons considering each person’s state of health, which might excuse one from fasting,” he explained.
“Those who are suffering from medical conditions, such as diabetes, hypotension or hypertension, may or may not be able to fast depending on their doctor’s opinion.”
“Exemptions exist for people with serious medical conditions, including many with diabetes, but a large number participate, often against the medical advice,” said Dr Basheer.
“Ensuring the optimal care of these patients during Ramadan is crucial. Ramadan fasting, therefore, represents a challenge to both patients and healthcare professionals.
“If you do not feel like eating right after the sunset, it’s fine,” he said. “Let your body decide the right time to eat. The digestive tract has been empty for about two-third of the day and needs to be dealt with cautiously. Besides, don’t forget to consume adequate amounts of fruits, milk, wheat and its derivatives, rice and meat.
“Fasting, the way it is recommended by abstaining from eating and drinking from dawn to dusk, is the best method to ensure a healthy body,” Dr Basheer went on to say. “Likewise, when someone comes down with an illness due to mal-temperament, the doctor should advise them to abstain from using food stuff that makes them sick in the first place and then start consuming food and drinks which help them to restore health.
Dr Basheer also advised patients to stay hydrated during Ramadan by ensuring they consumed enough fluids after the day’s fasting ended.
“Avoiding dehydration during fasting should be emphasised, especially when Ramadan occurs in hot seasons, by drinking ample amounts of fluids between Iftar and Suhoor,” he explained. “It is also highly recommended to maintain a well-balanced, healthy diet that is rich in fibres and has low salt content and a low glycaemic index.
“People who would like to exercise are encouraged to do so after Iftar,” added the doctor. “Although some fasting Muslims lose weight, regaining weight is commonly seen a few weeks after Ramadan. Therefore, individuals should be encouraged to have structured and consistent lifestyle modifications in order to avoid rapid weight gain after Ramadan. Those who start eating all the way from sunset until the time they go to bed might lose appetite for Suhoor, the meal consumed early in the morning by Muslims before fasting, which is an important meal and skipping it might cause problems.
“Generally one should eat light and try eating less before sleeping,” he revealed.
“It’s better to wake up early for Suhoor, about an hour or an hour and a half before the call for prayer, so that one gets hungrier as the dawn approaches, and does not feel full at that time.”
At the end of the day, though, Basheer said the decision to eat before the day’s fast began was a personal decision, one which couldn’t be made out of compulsion
“Existing recommendations on the management of people with diabetes who fast during Ramadan are mostly based on expert opinion rather than evidence gained from clinical studies,” he explained.
“Patients should be instructed on the use of glucose monitoring and frequency of glucose testing and patients receiving insulin should be monitored two to four times daily before, during, and after the fasting period.”