Ramadan is month long period of spiritual reflection, improvement and increased devotion to the Muslim religion. During this time, all religious believers are expected to concentrate their efforts on following the teachings of Islam and fast from dawn to sunset. The pre-dawn meal is called suhoor, and the meal that breaks the fast is called Iftar. According to the Quran fasting redirects the heart away from worldly activities and helps cleanse the soul by freeing it from harmful impurities.
“While a month-long fasting routine is a good way to cleanse one’s system and condition the body and mind, it can become a major health hazard for people suffering from lifestyle diseases such as diabetes. This brings up an important question and dilemma in every diabetic patient mind – to fast or not to fast and whether to prioritise their health and well-being over their religious belief and sentiments”, said Padma Shri Awardee Dr KK Aggarwal, President HCFI & Honorary Secretary General IMA.
From a medical perspective we advice:
- That patient with type 1 diabetes to avoid fasting as they run a high risk of suffering from hypoglycemia (low blood sugar).
- Patients suffering from type 2 diabetes, which is more common, can fast, however, they must keep the following points in mind during Ramadan to ensure that their health does not suffer:
- Drugs like sulfonylureas and chlorpropamide should not be taken while fasting as they can cause prolonged and unpredictable hypoglycemia.
- Drugs like metformin, pioglitazone, repaglinide are safe for Ramadan Fasting.
- The dose of longer-acting insulin should be adjusted and given before the sunset meal.
- Shorter acting insulins are safe
- All patients should end their fast if blood sugar reaches less than 70mg/dl or 300mg/dl.
It is advised that all diabetic patients who are going to be fast during Ramadan should undergo a pre- Ramadan assessment and get regular checkups during the month-long period. This will help them not only be aware of the necessary precautions that they need to take but will also help them understand the routine that they need to follow to ensure that their health does not suffer.