Dos and don’ts for fasting diabetics

Prevalence of diabetes is increasing around the world. Modern lifestyle and associated stress are considered major factors for the complication. The disease is no longer age or region-specific. Medical experts note that patients can only manage the disease as there is not permanent remedy available so far.
As the medical complication is directly related to eating habits and routines, there are genuine concerns from patients and doctors for those who are diabetic and are fasting during the holy month of Ramadan.
Gulf Times spoke with Dr Syed Shadab Ahmed, a medical practitioner and health and wellness expert associated with Zulal Wellness Resort. The resort blends traditional Arabic and Islamic medicine with a holistic health and wellbeing philosophy.
l Kindly explain diabetic disease and how to tackle it?
There are two types of diabetes with different levels of severity: Type 1 is an immune system disease, when the body attacks and destroys insulin-producing cells in the pancreas. With Type 2 diabetes, body cells do not allow insulin to function as it should to let glucose into the cells.
To manage diabetes, it is crucial to keep risk factors under control, keeping the blood glucose levels as near to normal as possible by following a diet plan, taking prescribed medication, and increasing activity level.
l Opinions on combining fasting and diabetes are controversial – some would recommend it, others – fully reject. Share your insights on fasting with diabetes, what are the pros and cons?
All diabetes patients willing to fast during Ramadan should ideally have a detailed health check-up at least one month before the start of the fast. This will allow the patient and the doctors to prepare and have a strict diabetes management plan well in advance, taking in consideration a history of hypoglycemia or hyperglycemia episodes.
Without taking these precautions, those who suffer from diabetes are likely to experience a severe hypoglycemic state during fasting days. The patients, classified as a high-risk group, should be carefully monitored at home by healthcare personnel. With proper dietary advice and guidance from a medical professional, it is possible to fast safely throughout the holy month.
l In which cases must a diabetic person avoid fasting so as not risk too serious health repercussions?
Changes in diet and physical activity levels during Ramadan are even more challenging for individuals with diabetes, and their risk assessment must be completed by healthcare professionals and completely individualised to avoid diabetic ketoacidosis and hypoglycemic risks. During such assessments, presence of comorbidities, complications, as well as individual, social and professional circumstances and previous Ramadan experiences must be taken in account.
l How can one manage hypoglycemia while fasting?
To successfully manage fasting and avoid hypoglycemia, it is advised to divide daily calories between Suhoor and Iftar, ensuring all meals are well balanced and include low glycemic index, high-fibre food that release energy slowly before and after fasting, like granary bread beans and brown rice. Minimising foods that are high in saturated fats and avoiding sugary desserts, caffeinated and sweetened drinks are the key to successful fasting for those with diabetic condition.
l What would you advise those with diabetes who would like to fast?
Such individuals must constantly monitor blood sugar and fluids, follow the diet advised by the medical professionals and break the fast in a timely manner, and make sure to take the medication adjusted accordingly.
l Can you share some practical wellness tips – fitness, diet, holistic practices – that those with diabetes can implement during Ramadan?
One must have moderate amounts of proteins with a preference to lean protein that stabilise glucose levels and preserves the energy throughout the day. Avoid breaking the fast with fruit juices as it causes a sudden spike in glucose levels.
Moderate activities are advised to attain maximum benefit and less exhaustion, take small breaks to keep the body dynamic and include 20 minutes of brisk walking that helps burn calories with short burst intensity.
Having a good oil head massage is especially beneficial for people with frequent headaches, intensified by dehydration. Acupressure and reflexology treatments are also a good way to boost the detoxification process in the body.