Tips for a healthy Ramadan with diabetes
Know your risk before you decide to fast
Based on medical and religious advice, it is recommended to visit your doctor 6-8 weeks before Ramadan to understand your risk category before deciding to fast.
Check your blood glucose regularly
Changes in eating habits during Ramadan may affect your blood glucose and therefore it is important check blood glucose levels regularly. They are your window to know your blood glucose levels and manage your diabetes. Blood glucose monitoring and insulin injections do not break the fast and are important. It is essential that patients have the means to monitor their blood glucose levels multiple times daily. This is especially critical in patients with type 1 diabetes and in patients with type 2 diabetes who require insulin.
* People at very high risk should check blood glucose levels 3-4 times a day
* People at moderate or low risk should check blood glucose levels 1-2 times a day
Medication adjustments during fasting
Talk to your doctor about the adjustments required to the dose, timing or type of medication to reduce the risk of low blood sugar. Regular adherence to your other medications including your blood pressure, heart and cholesterol tablets, etc
When to break the fast?
All patients should understand that they must always and immediately end their fast if:
* Blood glucose is lower than 70 mg/dl (3.9 m mol/L). Re-check within one hour if blood glucose is in the range 70-90 mg/dl (50- 3.9 m mol/L)
* Blood glucose is higher than 300 mg/dl (16.6 m mol/L)
* Symptoms of hypoglycemia, hyperglycemia, dehydration or acute illness occur
Exercising during Ramadan
Normal levels of physical activity may be maintained. However, excessive physical activity may lead to a higher risk of hypoglycemia and/or dehydration and should be avoided, particularly during the few hours before the sunset meal. Physical exertions involved in Tarawih prayers, such as bowing, kneeling and rising, should be considered part of your daily exercise activities.
Dietary advice for people with diabetes during fasting
* Divide daily calories between Suhoor and Iftar, plus 1-2 snacks if necessary.
* Include plenty of fruit, vegetables and salads
* Minimize foods that are high in saturated fats (ghee, samosas, pakoras)
* Use small amounts of oil when cooking (olive, rapeseed)
* Stay hydrated at or between the two main meals by drinking water or other non-sweetened beverages.
* Avoid caffeinated, sweetened drinks and sugary desserts
* Include low glycaemic index, high fibre foods that release energy slowly before and after fasting (granary bread, beans, rice)
When the month of Ramadan ends
Avoid over-eating (especially sweets) during Eid-ul-Fitr, as it may lead to high blood glucose. Visit your doctor to obtain guidance on changing the medication back to the previous schedule.
You may be able to fast safely during Ramadan if you understand the risks, manage your diabetes and carefully follow your doctor's recommendations.