Safe fasting with diabetes

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Safe fasting with diabetes
Blood glucose testing will not break your fast according to the Awqaf's fatwa.

Dubai - People should be careful to avoid low blood sugar and dehydration, particularly for those fasting in warmer climates.


Asma Ali Zain

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Published: Sun 12 Jun 2016, 8:05 PM

Last updated: Mon 13 Jun 2016, 9:40 AM

While healthy people can fast the entire month of Ramadan without encountering major health problems, a portion of the population who suffer from diabetes and want to fast are in a dilemma. Health experts, however, say that a number of lifestyle choices and personal management plans can help them sail through the month.
A major portion of the residents of the UAE suffer from the lifestyle disorder. In 2015, the UAE had one million cases, according to the International Diabetes Federation (IDF). Figures also suggest that the UAE is among the countries with the highest incidence of diabetes in the region with a prevalence of 14.6 per cent in adults above the age of 60. Anyone living with Type 1 diabetes is at high risk of complications when fasting and are therefore exempt according to Awqaf's fatwa.
Giving guidance and advice to people with diabetes, the Imperial College London Diabetes Centre (ICLD), Abu Dhabi, says that though it is possible to manage diabetes and fast, a doctor should be consulted.
"A healthy lifestyle must be maintained throughout the year and not just during Ramadan," says Dr Farhana bin Lootah, specialist internal medicine at ICDL.
"Being smart about your food choices and understanding the importance of portion control can make fasting an easier and more rewarding experience for diabetics."
"It is essential to remember that during fasting, our body slows down and uses alternative source of energy, such as the liver, to balance the glucose in our blood, and could affect prescribed insulin or other medication," she adds.
"I would advise anyone living with diabetes to speak to their doctor ahead of Ramadan so that a personal management plan can be drawn up," says Dr Farhana.
Healthy plate
Diabetics can make sure they are eating the right amount using the healthy plate method. They can also manage their diet by spacing out their meal, staying hydrated, consuming good carbohydrates as well as performing a moderate activity.
During Ramadan, our body, spirit, activity levels, sleep and dietary habits go through many changes, where activity/exercise, diet and medication being the three main factors affecting blood glucose levels.

Starting today, the following free events  will take place at the Medeor 24x7 Hospitals throughout June:
 June 12-16: Gastroenterology Department hosts talks on what and how to eat during non-fasting windows
 June 19-23: Consultations by Department of Internal Medicine to manage lifestyle diseases like hypertension, high cholesterol, diabetes and allergies
June 27-30: Paediatric Department host sessions to minimise the behavioural and lifestyle effects of fasting on children
To benefit from the free consultations at any of the Medeor 24x7 Hospital locations in Abu Dhabi, Yas Mall and Al Ain, or for any other inquiries, you can call 800-900-600.
"Of course, this year the fasting period is long meaning that the risk of hypoglycaemia or hyperglycaemia and dehydration is high," she says.
Blood glucose testing will not break your fast according to the Awqaf's fatwa. It is essential to monitor your glucose and be aware that you will have to break your fast and inform your physician if: The sugar is 70mg/dl or below with symptoms of hypoglycaemia (In this case, break your fast with either three dates, or half a glass of fruit juice, or one tablespoon of honey); or is more than 300mg/dl, as this will risk dehydration and the development of clots; You are nauseous and vomiting, or have any other severe illness.
Children with diabetes
Children living with diabetes require special attention by paediatricians as majority of guidelines and data on safety and metabolic impact of fasting are based on practice and studies on the adult population.
Type 1 diabetics should never stop insulin and only adjust medication according to the advice given by their physician.
"One healthy way to break your fast if you have type 2 diabetes is to distribute energy intake over two to three smaller meals. This may help you avoid post-meal hyperglycaemia."
Avoid caffeinated coffee, tea and energy drinks. Hyperglycaemia can lead to dehydration through excessive urination, and contribute to the depletion of electrolytes in the body.
Drink plenty of water
Dr Issam Badaoui, Medical Director at International SOS, says, "Regardless of the time of year, people should have a balanced diet, drink plenty of water, and get sufficient rest. These tips are particularly important for people who work and study. It is important for those who are fasting to drink sufficient water between Iftar and Imsak."
Adults should drink at least three litres of water during each 24-hour period. People should be careful to avoid low blood sugar and dehydration, particularly for those fasting in warmer climates.
With the number of admissions expected to rise during the fasting period, specialists from Medeor 24x7 hospital in Abu Dhabi organised a series of campaigns to help educate families on how to stay healthy as well as ease any discomfort they may feel while fasting this Ramadan.
Dr Anita Gupta, clinical dietician, says: "Take foods that are rich in complex carbohydrates and protein, fruits or vegetables, and plenty of water."
 Urinary tract infections
Dr Lalu Chacko, Chief Medical Officer at Burjeel Hospital, says: "During Ramadan, male youths are more susceptible to serious health concerns that often need specialised attention, such as urinary tract infections, kidney stones, etc."
Other common issues, which can become extremely serious if not managed correctly, are gastroenterology complaints such as excessive gas or belching, heart burn, abdominal pain or bloating, and in some severe cases, involuntary bowel movement as soon as the fast is broken.
Dr Taoufik Alsaadi, Consultant and Chairman of the Neurology Department, Chief Medical Officer at the American Centre for Psychiatry and Neurology, gives advice on common problems.
"Headaches during a fast can be due to dehydration or hunger, lack of sleep, hypoglycaemia or the absence of addictive substances, such as caffeine or nicotine," he says.
Reduction in caffeine consumption during the month of Ramadan can lead to caffeine withdrawal. "Coffee lovers should try and get their dose of caffeine intake during Suhoor."
Sleep deprivation is likely to happen and can result in lack of focus, increased temper, attention difficulties, and poor concentration.
"Changes in daily routine and shorter periods of sleep can lead to increased stress and even anxiety," he adds.

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