Diabetes and Fasting

Fasting is not meant to create excessive hardship on the Muslim individual. The holly Quran specifically exempts the sick from the duty of fasting (Al-Bakarah, 183–185).

Fasting during holy month of Ramadan, is an obligatory duty for all healthy adult Muslims. If you are a diabetic patient, before you begin fasting, your diabetes health care team can also advise you on what to do with your medication and how to keep good diabetes control.

For example, your diabetes team may advise you to change the

time, type or dose of medication to ensure your blood glucose levels are well controlled.

According to results of the population-based Epidemiology of Diabetes and Ramadan

1422/2001 (EPIDIAR) study, which showed (in 12,243 people with diabetes from 13 Islamic countries) that 43% of patients with type 1 diabetes and 79% of patients with type 2 diabetes fast during Ramadan. It is lead to the estimation that some 40–50 million people with diabetes worldwide fast during Ramadan.

As Ramadan is a lunar-based month, and its duration varies between 29 and 30 days. Its timing changes with respect to seasons. Depending on the geographical location and season, the duration of the daily fast may range from a few to more than 20 h.

The changes that occur in the body during fasting depend on the length of the continuous fast. Usually our body enters into a fasting state eight or so hours after the last meal. Our body will initially use stored sources of glucose and then later in the fast it will break down body fat to use as the next source of energy. It is because of our body goes into self-protection mode to preserve the integrity of cells and tissue until food starts coming in again, so it uses fats instead of glucose for fuel,"

In case of diabetes patients reducing extra body stores specially around waist area improve insulin sensitivity and help to better control of blood sugar.

Major risk related with diabetic fasting people are fluctuation in blood sugar levels, It could be lead to hyperglycemia(high blood sugar level) and hypoglycemia(low blood sugar level),also dehydration. Regular monitoring of blood sugar levels are vital for diabetes patients during fasting

All patients should understand that they must always and immediately end their fast if hypoglycemia (blood glucose of <60 mg/dl [3.3 mmol/l]) occurs, since there is no guarantee that their blood glucose will not drop further if they wait or delay treatment. The fast should also be broken if blood glucose reaches <70 mg/dl (3.9 mmol/l) in the first few hours after the start of the fast, especially if insulin, sulfonylurea drugs, or meglitinide are taken at predawn.

If this is the case, break your fast to consume a quick snack to normalize your blood sugar like a piece or two of fruit or a glass of natural fruit juice is usually sufficient to get your body back on track.

Finally, the fast should be broken if blood glucose exceeds 300 mg/dl (16.7 mmol/l). Patients should avoid fasting if they are uncontrolled diabetic patients.

During the fasting period, eating pattern may be very different compared to normal. Most people do eat 2-3meals per day during this period. However, it is important to keep to a balanced way of eating, including food from all of the food groups and not to eat excessively.

Especially diabetic patients should try to eat just before end of suhur (late Suhur) when they commence the next day fast.

Major dietary changes to be practiced are reducing glycemic index (gradual reduction of rate of a particular food which raise the blood glucose)of carbohydrate rich mix meal by consuming whole grain cereals, along with protein rich foods (Fish, chicken, egg whites, milk, nuts, pulses & legumes) also include acidic foods like fruits, lemon juice, vinegar & etc.

Normal levels of physical activity may be maintained. However, excessive physical activity may lead to higher risk of hypoglycemia and should be avoided, particularly during the few hours before the iftar meal.The timing of the exercise could be changed to nearly 2 hours after the iftar meal.

For further details on balance nutrition during month of Ramadan go through the following link

http://www.myeducationcity.com/en/dynamic_pages/index/496

Nutrition Clinic

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