Fasting with diabetes during Ramadan
As the holy month of Ramadan approaches, Muslims the world over will be fasting from sunrise to sunset – this means no food or fluids consumed for more than half a day. Most Muslims anticipate the practice, but those living with diabetes struggle with the potential risks fasting brings to their already fragile metabolic state.
Diabetics may suffer complications such as dehydration or hypoglycaemia during fasting hours, and hyperglycaemia after a breaking fast. Specialists at Abbot Nutrition (Malaysia), have prepared some guidelines to help diabetics observe a safe and worry-free Ramadan:
Run a fasting trial before Ramadan
A pre-Ramadan assessment helps you recognise any complications that might arise during and after Ramadan fasting, and how to address them. A trusted doctor will review your medical history, perform a risk assessment, advise on medication dosage and insulin routine, and evaluate whether fasting is safe for you.
Time and consume meals in moderation
Most Muslims time their daily sahur (pre-fast) meal and iftar (breaking fast) to avoid unnecessary mealtime delays. It is advisable to consume low-glycaemic index and high fibre foods that release energy slowly such as fruits and vegetables/grains including barley, lentils, and chickpeas. Diabetes-specific meal formulas such as Abbott’s Glucerna are also recommended to accompany a fasting meal plan, as it helps to regulate blood glucose levels and enable better glycaemic control.
[TIP: To safely raise your blood glucose levels after fasting, it is best to consume 2-3 pieces of date or a small plate of fruits and drink plenty of water to combat dehydration. Supplement your meal with formulas to replace a snack or two.]
Monitor glucose levels regularly
Besides planning meals, frequent blood glucose monitoring during fasting and non-fasting hours is crucial. Blood sugar levels should ideally be tested before sahur and two hours after iftar. This is useful to help recognise when the levels are low or high, and in some cases, if the situation requires breaking the fast, or medication or treatment.
For people with diabetes – or any medical condition – it is especially important to be aware of your body. Know that you can be exempted from fasting if your health is at risk.
Stay active
Exercise can lower blood sugar levels for people with diabetes, for up to 12 hours, thereby enabling the body to use insulin more efficiently. Light-to-moderate intensity workouts are encouraged for at least 30 minutes between iftar and sahur times – a brisk walk is a good start.
However, avoid excessive physical activity as it may lead to a higher risk of hypoglycaemia or dehydration, particularly before iftar.
Dr. Nina Mazera, Medical Director at Abbott Nutrition, said it is possible for diabetics to manage their condition way before the fasting month begins. “Fasting may be challenging for people with diabetes and therefore patient education is greatly emphasised as part of a successful Ramadan diabetes management. Individuals who insist on fasting often do well under supervision, with good compliance, and support. But if you are advised against it, heed your doctor’s advice.”
