Monitoring blood glucose imperative for managing diabetes during Ramadan

New Delhi , May 26 : According to statistics, India has the third largest Muslim population in the world. The month of Ramadan is about to begin and a vast majority of this population will be fasting for a large number of days.

 However, this number will also constitute those who are diabetic. While it is a personal choice for diabetics to fast during Ramadan, experts opine that there are ways in which diabetics can go about fasting by practicing caution.

Fasting can bring about metabolic changes and therefore, it is important to adjust the diet plan during the month of Ramadan, particularly for those with diabetes.

The gap between meals ranges from 12 to 15 hours during Ramadan. This can become a problem for diabetics as they are usually advised to have regular and timely meals.

Those with Type 1 diabetes are at a higher risk compared to those with type 2 diabetes when fasting during the holy month.

Speaking about this, Dr Sanjay Kalra, Consultant Endocrinologist, Bharti Hospital Karnal and Vice President, South Asian Federation of Endocrine Societies, said, "Ramadan, this year, starts in the month of May and goes on till June. The fasting period will also increase due to the daylight hours. Fasting for diabetics should entail consultation with the doctor and monitoring blood glucose levels regularly."

Adding, "The ability to fast safely is often influenced by the prescribed medication, and how controlled your diabetes is through the medications you take as also the food and activity. Those with Type 1 diabetes and a history of recurrent hypoglycemia are at a higher risk during fasting. Hypoglycemia and hyperglycemia can also occur in patients with Type 2 diabetes but not as frequently and with less severe consequences when compared to those with Type 1 diabetes."

Some warning signs to watch out for during fasting include a sudden fall in blood sugar levels (hypoglycaemia) causing seizures and unconsciousness; and an inordinate increase in blood sugar levels (hyperglycaemia) causing blurry vision, headache,



increased fatigue, and thirst. If any such conditions persist, your GP may advice you to do away with fasting completely.

Adding further, Dr Kalra, said, "People with diabetes must keep their body nourished during these months but with healthy food. It is a good idea to consume carbohydrates with a low GI such as brown rice and full grain bread and vegetables. For those who have a sweet tooth, it is a good idea to consume smaller portions of these. Other good sources of energy include nuts, oily fish, avocados, olives, and olive oil as they help in increasing the HDL (good cholesterol) levels. An added concern this year is the occurrence of Ramadan in summer. Those with diabetes must ensure that they consume a diet that is rich in water content (such as fruits) so as to avoid getting dehydrated."

There are many misconceptions regarding fasting among those with diabetes. An example is pricking the skin for blood glucose testing invalidates the Ramadan fast.

However, this is not the case. The need of the hour is awareness programmes that can provide individuals with the requisite knowledge and tools to effectively manage their condition during Ramadan by making key changes to their behaviour and lifestyle and thereby minimize risks.

Here are some tips to follow during Ramadan for those with diabetes.

• Monitor blood sugar level frequently.

• Do not overeat. Pay attention to body signals and understand hunger.

• Make sure to break the fast with sugar-free and decaffeinated drinks to avoid dehydration

• Consume sweets in a limited amount.

• Make sure to include lot of fruits, vegetables, pulses, and curd in your diet

• Allow a time interval of at least 2 hours between the meal and bed time. It is a good idea to avoid complex carbohydrates right before bedtime.

• Avoid deep fried foods. Also, make sure to time the consumption of starch-containing foods such as rice and rotis.