Decreased food intake during Ramadan is considered a risk factor for the development of hypoglycemia among individuals with diabetes who choose to fast.
Abstention from food and fluids for approximately 15 hours a day can cause a sharp drop in blood glucose levels in people with diabetes who then may not have enough energy to perform their normal daily activities, Dr. Mahmoud Ali Zirie, senior consultant and head of HMC’s Endocrinology and Diabetes Division, explained.
Generally, diabetes is divided into two types: Type 1 and Type 2. Patients with Type 1 are dependent on insulin and more prone to sudden hypoglycemia so they are advised not to fast. Patients with Type 2 are generally not insulin dependent.
Hypoglycemia generally occurs when a diabetic patient significantly alters their dosage of oral hypoglycemic agents or insulin, misses a meal, for example, the pre-dawn meal during fasting, or performs excessive physical activity, Dr. Zirie explained.
Initial symptoms of hypoglycemia include trembling, increased hunger, perspiration, a quickened heartbeat, lack of concentration, irritability and confusion. These symptoms must be addressed immediately. If left untreated, they may develop into more serious symptoms such as convulsions and loss of consciousness.
When the initial symptoms of hypoglycemia appear, patients should check their blood glucose level and break their fast. Unconscious patients should not be given any beverages, to avoid the risk of choking and urgent medical care should be sought.
Hypoglycemia is more dangerous than hyperglycemia as patients with hypoglycemia are susceptible to losing consciousness.
Dr. Zirie stresses that this is particularly concerning in instances where the individual may be driving or standing an elevated location.
Before deciding to fast, patients are advised to seek advice from their healthcare provider on a treatment plan, medication dosages and diet. Diabetics should also get into the habit of carrying sugar pills or packages of sweetened juice, which should be consumed if symptoms occur.
Fasting diabetic patients should also limit their intake of dates to one or two per day, just enough to raise their blood sugar level before Iftar. They should consume whole bread and long-lasting proteins, such as cheese and eggs at Suhoor.
It is advisable to have a snack, preferably fruit, between the two meals and to take some light exercise, such as walking, afterwards. Individuals with diabetes who fast should also take care to consume sufficient amounts of fluids, such as water, soup and sugar-free juices, to avoid dehydration.
Tips and information about living well with diabetes during Ramadan, and the rest of the year, are also available at diabetes.hamad.qa