The Ramadan fast, during which no food or drink is consumed during daylight hours, is one of the five pillars of the Islamic faith. Fasting is believed to encourage self-control, purification, spiritual strength and awareness of those less fortunate. Ramadan lasts for one lunar month.
Ramadan fasting is obligatory for the healthy adult but, when fasting might significantly affect the health of the fasting individual or when one is genuinely sick, you can be exempted. This brings us to diabetes. What to do if you have diabetes?
During the fast, diabetics should be capable of home glucose monitoring, checking urine for acetone, doing daily weight measurements, maintaining a calorie-controlled diabetic diet, and understanding the need for sleep and normal exercise. They should be able to check their pulse and temperature, look for skin infection and notice changes in their mental alertness. They should be on special alert for any colicky pain, a sign for renal colic, or hyperventilation, a sign of dehydration, and to be able to seek medical help quickly rather than wait for the next day.
Diabetics who are controlled by diet alone can fast and hopefully with weight reduction, their diabetes may even be cured or at least improved. Diabetics who are taking oral hypoglycemia agents like Orinase along with the diet should exercise extreme caution if they decide to fast. They should reduce their dose to one-third, and take the drug not in the morning, but with Iftar in the evening. If they develop low blood sugar symptoms in the day time, they should break the fast immediately. Diabetics taking insulin should not fast. If they do, at their own risk, they should do so under close supervision and make drastic changes in the insulin dose. For example, eliminate regular insulin altogether and take only NPH in divided doses after Iftar or before Sahar.
Diabetics, if they fast, should still take a diabetic diet during Iftar, Suhur and dinner. The sweet snacks common in Ramadan are not good for their disease. They should check their blood sugar before breakfast and after ending their fast.
You should eat foods high in dietary fiber and have a low glycemic index (GI) diet at the pre-dawn (Suhur) and sunset (Iftar) meals to promote glycemic control and discourage foods with a high glycemic index until about half an hour after taking drugs to minimise sharp rises in blood sugar at sunset. Whole wheat, grains, seeds, vegetables (like peas, beans, spinach), prunes, dates, apricots, figs etc are all examples of low GI high dietary fiber foods.
If possible, consume your meal or part of your meal just before sunrise, helping to spread out the time it takes to metabolize your food. Make sure that you eat a balanced diet of fruits, vegetables, and yogurt. Make sure that any drinks you consume are low calorie and sugar free.
If you put some thought into how you plan to break your fast, and if your doctor says that it is ok, you should be able to safely fast during Ramadan.
