For people who have diabetes, fasting for long hours can lead to complications like hypoglycemia (low blood sugar), hyperglycemia (high blood sugar) and dehydration, mentions International Diabetes Federation (IDF) on its official website.
Diabetics are therefore advised to consult a doctor before fasting during Ramadan. There is one particular set of guidelines for every diabetic, Dr Subhash Kumar Wangnoo, senior consultant, endocrinology, Indraprastha Apollo Hospitals, New Delhi, tells indianexpress.com. Adjustments in medication and other precautions are advised based on the diabetic’s medical condition.
Here’s what the doctor suggests:
* “We have to very cautious that one does not take those drugs which can cause hypoglycemia,” the doctor says. Long-acting oral drugs should be avoided during Ramadan since people are fasting for long hours during the day. Diabetics should avoid taking sulphonylurea (medication to control blood sugar level by stimulating production of insulin) since they are long-acting. Instead, they should opt for short-acting drugs like gliptins or metformin to avoid low blood sugar during the daytime.
*During Ramadan, diabetics should also avoid having SGLT2 (sodium-glucose co-transporter-2) inhibitors, used for treating type 2 diabetes by helping kidneys to lower blood sugar levels.
*Diabetics can have gliclazide, another short-acting drug that does not cause hypoglycemia.
One should monitor his or her blood sugar levels regularly and not skip insulin injections, IDF states.
Dr Wangnoo says, “If the patient is on two doses of insulin, he or she should reduce the dose by one-third. If the patient is on multiple doses of insulin, he should avoid fasting during Ramadan.”
When to break the fast?
The moment one starts sweating or experiences palpitations, they should immediately check their blood sugar level. If the blood sugar levels go lower than 70 mg/dl, one has to break the fast.
“Avoid over-eating (especially sweets) during Eid-ul-Fitr, as it may lead to high blood glucose. Visit your doctor to obtain guidance on changing the medication back to the previous schedule,” IDF also mentions.
Apart from this, pregnant women, children, elderly patients with co-morbid conditions like high pressure, heart disease or high cholesterol, should avoid fasting during Ramadan, the doctor warns.