Diabetics should get medical advice before fasting

Endocrinologists say changes in eating patternscan put people at the risk of complications

Although doctors advise against fasting and feasting for diabetics, the devout insist on doing it. The best way is to get medically assessed before the fasting month of Ramzan, say doctors.

The American Diabetes Association and ayurveda practitioners stress on the importance of seeking medical advice and undergoing pre-Ramzan assessment for better management of the condition during the fasting month. People with diabetes have a high risk of developing fasting-related complications during Ramzan, say doctors.

City-based endocrinologists say changes in eating patterns during Ramzan can put people with type 2 diabetes (those who have insulin resistance) at the risk of complications such as low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), thrombosis and dehydration.

Consultant diabetologist Aravinda Jagadish says the risk of hypoglycemia in type 2 diabetics who fast is because of decreased food intake apart from certain medications. Symptoms of hypoglycaemia include sweating, dizziness, hunger and irritability.

Asserting that people with type 1 diabetes (insulin-dependent) and uncontrolled diabetes should not fast, Dr. Krishna from Shatayu Ayurveda says tailored management of diabetes including treatment changes could help minimise the risks.

Raja Selvarajan, Consultant Diabetologist, Apollo Sugar Clinic, says blood glucose levels are likely to go down during the day when one is not eating. In individuals who take insulin or diabetes medication, the risk of hypoglycaemia (low blood glucose) occurring is much higher. He says it is advisable to limit physical activity during fasting hours and be more active after sunset.

It is also important to know what to eat if you are a diabetic and are fasting, say doctors.

“Blood glucose levels naturally go up after breaking the fast ( iftar ). The risk is when glucose levels go too high and this happens as a result of overeating or eating too many sugary foods. Watch out for eating too many sweets and keep the portion sizes moderate,” says Dr. Selvarajan.

Apart from taking care to have a balanced meal and not straying away from the diabetic diet, the iftar should be split into two snacks and a meal. While breaking the fast, dates should be replaced by fruits and oily/fried food should be avoided, the doctors add.