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21 July 2012

Diabetes patients may skip regular fasting: Prof. Jamal Ahmad

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IMO News Service

Aligarh: Prof. Jamal Ahmad, Director, Rajiv Gandhi Centre of Diabetes and Endocrinology, J. N. Medical College, Aligarh Muslim University while delivering a lecture on "Diabetic Emergencies including Hypoglycemia during Ramadan" elaborated on the effects of Ramadan, the Muslim month of fasting, on the health of diabetes patients.

He said that fasting in Islam means absolute self-restrain from food, drink and sex from dawn to sunset which is not a very difficult duty for healthy people. However, Qurāan specifically exempts people with a medical condition from the duty of fasting, especially if it might have harmful consequences. People with diabetes also fall within this category as it is a chronic metabolic disorder which can place them at high risk for various complications, if they decide to observe fasting.

Prof. Jamal Ahmad
Prof. Ahmad said that the population-based epidemiology of Diabetes and Ramadan (EPIDIAR) study involving 12,243 persons with diabetes in 13 Islamic countries found that about 43% of people with type-I diabetes and 79% of people with type-2 diabetes fast during Ramadan. Some of the major potential complications associated with fasting in patients with diabetes are Hypoglycemia, Hyperglycemia, Diabetic ketoacidosis and Dehydration and thrombosis. Limitation of fluid intake during the fast is a cause of dehydration. Dehydration may become severe in hot and humid climates and among individuals who perform hard physical labor.

Prof. Ahmad added that patients should be encouraged to maintain their good dietary habits and to resist any temptation to break their dietary restrictions, as during Ramadan, social functions are frequent and food is a common way of hospitality. It is always emphasized that adherence to diabetic diet is essential during Ramadan in order to avoid the potential risk of hypoglycemia.

Regular consultation with the doctor, keeping the weight record, observing the warning symptoms of hyperglycemia and hypoglycemia and taking medicine regularly is essential for diabetes patients. They must seek medical help and resist any temptation to persevere fast till the end of the day if a complication occurs. Normal level of physical activity may be maintained.

It is essential that patients have the means to monitor their blood glucose level multiple times daily. This is especially critical in patients with type 1 diabetes and in patients with type 2 diabetes who require insulin.

Patients should understand that they must always and immediately end their fast if hypoglycemia occurs since there is no guarantee that the blood glucose will not drop further if they wait or delay treatment. The fast should also be broken if blood glucose reaches low in the first few hours after the start of the fast. Finally, the fast should be broken if blood glucose exceeds. Patients should avoid fasting on "sick days."

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