Practical tips for managing diabetes well during Ramadan

In just a few days, the holy month of Ramadan will begin. More than 1.5 billion Muslims across the world will abstain from food and drink from dawn until sunset. In Algeria, this makes an average of 13 to 15 hours of dry fasting per day.

If Ramadan, 4th pillar of Islam, represents a very important religious ritual, it is however not without risk for certain categories of people, in particular diabetics. What good practices should they adopt to preserve their health?

Fasting and diabetes: what are the risks?

For people with diabetes, fasting induces a disturbance in the eating rhythm which, associated with taking antidiabetic drugs, can lead to hypoglycemia (low blood glucose level). Without treatment, these seizures are likely to cause loss of consciousness, or even seizures.

In addition, the main risks associated with fasting are:

• dehydration: loss of the water that makes up the body;

• hypoglycaemia: low blood sugar level;

• hyperglycaemia: excess sugar level in the blood;

• diabetic ketosis: presence of ketone bodies in the blood.

People with diabetes on insulin, those with inadequate glycemic control, those with frequent episodes of hypoglycemia and those no longer experiencing symptoms of hypoglycemia – constitute particularly high-risk profiles. The existence of complications, acute illnesses, and certain specific situations (eg physical work, intensive sport, heat wave) also increase the risks associated with fasting.

In order to accomplish your fast safely, it is essential to check with your doctor the following points:

• Diabetes control;

• Blood glucose monitoring;

• Medication;

• The risks of fasting;

• General state of health.

In addition, a person living with diabetes must know that certain situations could oblige him to break the fast. This is the case if it occurs: hypoglycemia (glycemia below 4.0 mmol/L) or significant hyperglycemia (glycemia above 16.5 mmol/L).

Maintain healthy lifestyle habits

Beyond fasting, Ramadan brings a drastic disruption of lifestyle habits, especially meal times and sleep patterns. Indeed, many people stay up all night and only sleep after the s’hour meal. These changes profoundly affect the management of diabetes, and for this reason some advice is in order.

In the evening, after breaking the fast, you must:

• Keep a regular schedule for meals.

• Avoid continuous nibbling.

• Eat balanced meals.

• Drink enough water to rehydrate.

During s’hour (morning meal, before sunrise): favor foods containing slow-absorbing carbohydrates (harira, semolina, beans, rice, etc.).

During iftar (breaking the fast): start with foods that contain fast-absorbing carbohydrates (fruits, dates), otherwise drink a little water, then eat foods that contain slow-absorbing carbohydrates.

And at all times:

• Avoid intensive physical activity.

• Measure blood glucose frequently.

• Consult a physician as soon as a problem arises.

Finally, you should know that according to the Koran, diabetes is one of the situations that authorize the exemption from fasting given the health risks. Allah, the Most High, says: “Whoever of you, sick or traveling, is prevented from doing so must fast later a number of days equal to the number of fasting days not observed. God wants to make it easier for you to fulfill your religious duties and not to make it difficult for you. (Qur’an, II: 185)

Article sponsored by Anadolu Medical Center.

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