Ramadan and diabetes

Fasting during the holy month of Ramadan is an important spiritual practice.  Fasting is not meant to create hardships on Muslims, according to religious tenets. When you have diabetes, you may be wondering how fasting will affect you.  There is a lot of misinformation about diabetes and Ramadan.

According to the Holy Quran and the teachings of Islamic religious scholars, some groups of people are exempt from fasting, especially if it puts their health at risk.

Many people with diabetes can fast safely, but each person is different.  It is important to discuss with your physician and take a decision as it requires changes in your medications.  It is important to schedule an appointment 2-3 months before Ramadan to discuss how fasting might affect your diabetes.

Checking blood glucose while fasting will not break a fast. It is important to monitor blood glucose particularly to identify low glucose level (less than 70 mg/dl).  If blood sugar is < 70mg/dl, you may feel dizzy, trembling, palpitations, sweaty and feel tired/ fatigued. If you experience hypoglycaemia you may have to break the fast and take fruit juice/ glucose drink/ tender coconut water after 10 – 15 minutes have a snack/ small meal. Never ignore the warnings of hypoglycaemia.

Some risks one must be aware of

  • Low blood glucose – The risk of blood glucose levels going too low is highest in people taking insulin or certain diabetes pills. Limit physical activity during fasting hours and be more active after sunset.  Talk with your doctor to find out if your medicine can cause low blood glucose and discuss how to prevent it.  

  • High blood glucose – While low blood glucose levels may happen during the day, after the fast is broken, there is a greater risk to overeat.  Avoid eating too many sweets and eat small meals.  Let not the evening meal be a feasting meal. Symptoms of high blood sugar are feeling very thirsty, passing a lot of urine, feeling extremely tired.

  • Dehydration – This is especially a problem during the longer and hotter summer days.  Try drinking  sugar– free and caffeine free drinks frequently throughout the evening and before dawn. People on diuretics for high blood pressure may be prone to dehydration.

Tips for healthy eating

The dawn meal (Suhoor) should contain a balance of whole grain sources of starchy carbohydrates as well as some protein and fat to help slow the digestion and help the feeling of fullness last as long as possible into the day.  

  • Whole grain cereals (wheat, rice, ragi), low-fat milk, lean meat, fish (steamed), egg white, dhals, legumes, peas, khichdi,
  • Small servings of fresh fruits such as water melon, papaya, orange, mosambi, few grapes, pine apple and vegetable salads.
  • Curds with a pinch of elaichi powder (cardamom) taken after dawn meal will  prevent from feeling thirsty  
  • Avoid consuming high-fat foods, bakery products and deep-fried foods like samosa, pakoras, bajji etc.
  • Avoid overeating in Suhoor as it may cause indigestion and postprandial hyperglycemia. Eat Suhoor just before sunrise and not at midnight.
  • Avoid consuming carbonated beverages like sod’s and cola’s after breaking fast.

Traditionally the fast is broken (Iftar) after sunset and begins with the eating of dates and drinking water.  Limit dates to 1-2 each evening.  Drink plenty of water and sugar free beverages in the evening. 

Make sure you eat evening meal before going for Taraweeh prayers, carry some water (keep yourself hydrated) and glucose (for emergency).

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