Not so fast, say doctors Diabetics can enjoy Ramazan

People with diabetes need not refrain from fasting this Ramazan as doctors suggest what, when and how to eat.

Express July 30, 2010

KARACHI: People with diabetes need not refrain from fasting this Ramazan as doctors suggest what, when and how to eat.

The Pakistan Medical Association (PMA) held a lecture titled, “Diabetes and Ramazan” at PMA house on Thursday for doctors and general practitioners to inform them how to treat diabetic patients so that there are no medical complications for those who want to fast.

Eating one date at iftari is more than enough, said Dr Khurrum Shahid, a consultant in diabetes and endocrinology. “Any diabetic patient can fast during Ramazan if they take care of their diet, unless the diabetes is at a very high level,” he said. Doctors should use the 3 D’s approach that includes drug regimen adjustment, diet control and daily activity.

Since dietary patterns change during Ramazan, the drugs prescribed to patients must also change accordingly, he said, emphasising that patients must control their diet. Routine exercise and daily chores have no effect on blood-sugar levels and can be carried out as usual, he clarified.

Risks associated with fasting

According to Dr Shahid, the risks associated with fasting are hypoglycemia (low sugar level), hyperglycemia ( high sugar level), ketoacidosis (coma) and dehydration that may lead to the complications for the patients but there are checks and measures that they can take to avoid such a situation.

Dietary recommendations

Diabetic patients must increase their fluid intake, avoid food that is rich in fats and complex carbohydrates, such as sweets, juices and fried food, said Dr Shahid. He suggested that patients take simple carbohydrates, such as chappatis, bread and milk with cereal, at sehri time and have their sehri as late as possible.

“Chappati is the best form of food for diabetic patients,” said another doctor at the seminar. “It is also believed that a cup of any fruit and grilled samosas are also not very harmful for those who really want the flavour of Ramazan,” he added.

Breaking the fast

While some patients believed that it will be against their religion if they break their fast before iftari, it is sometimes a medical requirement, said the speakers at the lecture.

“The doctors must inform their patients that they might need to break the fast before time and not avoid the topic,” said a doctor. “Patients should break their fast if the blood glucose is less than 60 milligrammes per decilitre (mg/dl), if the sugar is less than 70mg/dl in the first few hours after sehri or if the blood sugar level is greater than 300mg/dl at any time,” he said.

Fasting is, however, inadvisable for pregnant women and mothers who are feeding their children as the baby acquires nutrition through the mother, said Dr Samreena Hashmi, former general-secretary PMA.

Published in The Express Tribune, July 30th, 2010.


Diabetic Working Mom | 11 years ago | Reply Thanks a lot for the very useful article and comments with information on just what I was looking for. Frankly, I had wondered about the test prick issue as well and find myself completely agreeing with namazi-banda's views. However, I will check the actual ruling on the issue as well just to make an informed decision as I would like to check my sugar level atleast twice during the fast and once after breaking it. The 70-300 sugar level guideline is a very good tip to have in mind as well. A little more work would be needed in exploring whether pregnant diabetics should fast or not as I know that fasting in not exempted even in pregnant non-diabetc women and the majority fast except in the case of a life threatening situation to mother or baby. I think again the self-test prick tracking would actually help more women to fast rather than skip them and feel guilty or keep them and endlessly worry about their own or their baby's well-being. Would love a follow-up article elaborating the above issues.
namazi-banda | 11 years ago | Reply @ Tariq, Hi Tariq, I am not a maulana, though your comment intrigued me. I believe things as such are to be taken in line with one's intentions. If one is fasting, and gets a papercut, or falls and scrapes his knee and is bleeding, I think it would be silly to start eating and saying your fast is over and there is no point, Allah (swt) is aware of all circumstances. Similarly, if one is fasting, and suffers a serious injury for which it would require him or her to have food or water, then it would be wise to break the fast and make it up at the end of Ramzaan. As for the issue in this article, I think that if a person has diabetes and must maintain a particular blood sugar level or prick his finger to check, I highly doubt his fast would be rejected if he had pure intentions and did his best. I personally think it is strange when someone accidentally eats something, and then justifies eating the rest of the day by saying "Oh I accidentally broke my fast", we should all try our best to please Allah; instead of eating the rest of the day, how about praying that Allah forgive you for that accidental sip of water you had..."Ar-rahmanir Raheem", "oft forgiving, most merciful"...
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