The holy month of Ramadan, a very significant time for many Muslims worldwide, will soon be upon us. However, for diabetic people out there who would like to embark on the fasting journey, this central religious period poses some possible challenges.
Restraining from food and fluids during the day, and consuming a rich evening meal afterwards, is posed to create a heavy health risk on people having diabetes such as having to deal with periods of hyperglycemia and hypoglycemia whether they are living with Type 1 or Type 2 diabetes… with those who change the dosages of their oral medications or insulin being the most vulnerable ones.
“According to the EPIDIAR Study, a population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries, a large percentage of people with diabetes, 43% for type 1 diabetes patients and 79% for type 2 diabetes, do fast for more than 15 days during the holy month of Ramadan despite physicians’ recommendations not to fast,” explained Dr. Ibrahim Al Salti, Head of the division of Endocrinology and Metabolism at the AUBMC, at a press gathering in 2015.
“Fasting for people with diabetes represents an important personal decision, and should be made after a careful consideration and understanding of the associated risks and the way to manage them. Educating patients who still choose to fast despite having diabetes is key to achieve a safe Ramadan fasting experience and necessitates the availability of the right tools and resources, including time and personnel,” explained President of the LSEDL, Dr. Mounzer Saleh, while stressing how significant the decision to fast is for the diabetic individual.
He recommended all patients who choose to fast during Ramadan to consult their endocrinologist to establish a pre-Ramadan individual management plan.
It is crucial to determine an individual’s risk level:
- Very high risk and high risk: Advised not to fast as it can lead to worsened control and may result in severe hypoglycemia and diabetic ketoacidosis.
- Moderate risk: Advised to see healthcare provider several months prior to fasting to adjust their diabetes treatment.
- Low risk: Can fast without healthcare advice.