Ramadan and Diabetes Management


Diabetes mellitus is a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood.

Ideally, in case of diabetes fasting is not allowed. However during Ramadan, if you really like to keep fast, following guidelines will help you.

Lower risk – Healthy individual with hba1c lower range than 7.0% and treated with oral medications. May choose to fast but observe the body changes.

Moderate risk – Healthy individual with hba1c lower range at 8.0% and treated with oral medications. May choose to fast but always take precautions.

High risk – Individuals with the complications with uncontrolled sugar control are not advice to fast. A person with type 1 diabetes, severe hypo or hyperglycemia symptoms, acute illness, intense physical labor, pregnancy, renal conditions, on dialysis.

All those under high-risk category are not allowed to fast.

For the good and normal blood sugar control always follow a healthy diet. Which include complex carbohydrates, high fibre food, good quality protein, healthy fats.

In order to minimise adverse side effects during fasting in patients with diabetes and improve or maintain glucose control, education and discussion of glucose monitoring and treatment regimens should occur several weeks prior to Ramadan

A condition of blood glucose elevation is hypoglycemia and hyperglycemia.

In case hypoglycemia person feels palpitation, weakness, shakiness, dizziness, sweating, anxiety, nervousness, headache. So watch or observe for the symptoms.

Recommendations for prevention of hypoglycemia during Ramadan

  • Blood glucose monitoring. Depending on treatment regimen, monitor glucose levels daily or several times a day. Patients treated with insulin and insulin secretagogues should measure glucose before, during, and after fasting (2–4 times daily).
  • Consultation with diabetes healthcare provider for medication adjustment.
  • Avoid skipping predawn meals
  • Avoid strenuous physical activity during fasting period
  • Eat a snack in the presence of hypoglycemia. Consider breaking the fast if there is severe or recurrent hypoglycemia
  • Record blood glucose measures to determine patterns contributing to hypoglycemia
  • Patients and family members should receive instructions on treatment of hypoglycemia.
  • A common error is to over treat hypoglycemia with an excess intake of carbohydrate.
  • Below lists the common sources of 15 g of carbohydrates that are usually sufficient to correct mild-to-moderate hypoglycemic events.
  1. The following are examples of 15 g of carbohydrate:
  2. Four ounces (1/2 cup) of apple or orange juice
  3. Four ounces (1/2 cup) of regular sweetened soda
  4. Three or four glucose tablets
  5. One serving of glucose gel—the amount equal to 15 g of carbohydrate
  6. Eight ounces (1 cup) of milk
  7. Five or six pieces of hard candy
  8. One tablespoon of sugar or honey

Hyperglycemia is a condition when your blood sugar levels are more than the normal range. This is more than 200 mg/dl.

Classic symptoms are increased thirst, increased hunger pains, frequent urination, blurred vision, confusion, dry mouth and headache.

To avoid this take a medication guidelines, healthy diet before and during Ramadan.

Dr. Sushama Ghag 

Dietitian

Aster Hospital Mankhool

To know more about Dr. Sushma Ghag

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