KOCHI:Almost all diabetologists should have faced this question from their patients at least once: “Doctor, Can I take Ramzan fasting?” Even though the Holy Quran has mentioned “It is not compulsory for people with ill health to take Ramzan fasting, better they can do good deeds”-People won’t satisfied without taking fast.
The decision about fasting depends on the stage of diabetes, its complications and the medications taken by the patients. Fasting may result in hypoglycemia and dehydration in people with diabetes. Patients with diabetes can be divided into three categories to decide about fasting.
Very high-risk patients
People in this category should avoid fasting. People who have severe hypoglycemia or hypoglycemia in last three months, people with diabetic kidney diseases, diabetic retinopathy, people who had heart attack, people with hypoglycemia unawareness due to autonomic neuropathy, old people with diabetes, people undergoing dialysis, Type 1 diabetic people, people with memory loss and pregnant women falls in this category.
High-risk Patients
These patients should also better avoid fasting. People with uncontrolled blood sugar values, people on medicines that can cause hypoglycemia, people with long-lasting diabetes and people having diabetic neuropathy.
Moderate to low-risk patients:
This category patients may take Ramzan fasting. They are people with well-controlled blood sugar by diet, exercise or medications, people who do not have chances of hypoglycemia.
What to do before starting fasting
It is better to consult the treating doctor and adjust the medications before the start of fasting. It should be made sure that medicines which can cause low sugars should be taken only in the evening just before breaking the fast. People who are on insulin should regularly check blood sugar values and take insulin accordingly. People can also be changed to the newer insulin which won’t cause low sugars.Nowadays there are a lot of medicines available in the market which won’t result in hypoglycemia and hence people can take these medicines.Fasting all the day and feasting at night is not a healthy habit. People should follow dietary restrictions even during fasting. They should avoid sugars as well as fatty foods. A small quantity of food should be taken at intervals. Also, sleep should not be avoided. It is compulsory to take food early morning before starting the fast. Also, people should drink plenty of fluids and they should take fruits in moderate quantities.
Take Care of Hypoglycemia
People should be cautious about the symptoms of hypoglycemia such as a headache, fatigue, shivering, sweating. If any of such symptoms occur blood sugar should be checked immediately. If blood sugar values are low its better to take food. Diabetic patients should never stop medications on their own during Ramzan fasting. Stopping medicines without advice from doctors can result in complications. Moderate exercise like walking can be continued during fasting also. As the state of diabetes is different for each individual the decision about fasting should be taken only after discussing with the treating doctor. Wishing all a healthy Ramzan fast.
Dr Sheeja Srinivas Edamana
Asst Surgeon
Govt. Hospital, Ayyampilly, Ernakulam
(The views expressed by the author are his own)