Health and the holy month: Dos and Don'ts during Ramadan

Some dos and don’ts in Ramadan

• Do not eat so many sugary foods at iftar

• Have fruits, vegetables, pulses and yoghurt in your meals

• Have more meal at Sehri just before sunrise and not at midnight

• When you have a drink, have sugar free drinks

• Do not have too many fried foods

• Fluid intake should be encouraged during non-fasting hours

• Having large amounts of food at iftar meal should be avoided

Who can fast:

• All healthy adult Muslims

Who cannot fast:

• Physically sick
• Traveler on a journey
• Women during menstruation
• Pregnant and lactating women
• Prepubertal children

Blood sugar monitoring:

• Blood glucose monitoring does not constitute break of fast
• It is important to identify low glucose levels
• A fast will have to be ended if glucose levels fall too low (70 mg/dl).
• Exercises:
• Normal level of physical activity may be maintained. However, vigorous physical activity may lead to hypoglycaemia
• Taraweeh prayer should be considered as part of the daily exercise programme.

Medical assessment

• All patients with diabetes who wish to fast during the holy month should undergo medical assessment and educational counselling.
• Specific attention should be given to overall well-being of patient and to control of their sugars, blood pressure and lipids.
• During this assessment, necessary changes in their diet or medication regimen should be made.

Complications:

• Patients should be aware of the warning symptoms of dehydration, hypoglycemia and hyperglycemia, and should break fast as soon as any complications or acute illness occur.

Can people with diabetes fast:

• Many people with diabetes can safely fast, but each person is different.
• Patient with type I diabetes or type 2 diabetes mellitus on mixed insulin or those with very high and very low sugars may not be permitted

Key areas in Ramadan education:

• Meal planning and dietary advice
• The diet in Ramadan should be healthy and balanced.
• Slow energy release foods (such as wheat semolina, beans, rice) should be taken before and after fasting, whereas foods high in saturated fat (such as ghee, samosas, pakoras) should be minimised.
• Have high fiber foods such as wholegrain cereals, granary bread, brown rice, beans and pulses, fruits, vegetables, and salads.

Counselling:

• Patient should receive education concerning self-care, signs and symptoms of hypoglycemia, blood glucose monitoring, meal planning and physical activity.

Risks

• Low blood glucose (hypoglycemia) is especially seen in people taking insulin or certain diabetic pills
• High blood glucose: After the fast is ended, there is a risk to overeat leading to high blood sugars
• Dehydration especially seen during longer and hotter summer days.

Key points:

• Discuss with doctor if you are planning to fast
• Check your blood glucose levels more often
• Take a balanced diet
• Include more starchy carbohydrates and slowly absorbed foods
• Try not to have many sugary and fatty foods

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