Dubai, United Arab Emirates, May 16, 2018:  The Dubai Diabetes Center, a specialized multi-disciplinary diabetes care and management center of Dubai Health Authority, discussed the importance of diabetics taking certain precautions while fasting during the Holy month of Ramadan.  

Abdulla Mohamed Juma, Director of Administrative Affairs at the Dubai Diabetes Center said, “A majority of our patients prefer to fast during Ramadan despite having diabetes.

While they are aware that they are exempt from fasting as it can have an adverse effect on their health, they are keen to follow all the rituals of Ramadan.

Therefore, we at the DCC provide them with all the information and medical advice necessary to ensure they do not suffer from complications of fasting.”
 
The centre meets patients individually prior to the Holy month of Ramadan to check if the patient is medically capable of fasting as well as to adjust their medication and provide an individualized diet plan. 
 
Dr M. Hamed Farooqi, Director of the Dubai Diabetes Center Dubai, elaborated, “While everyone needs to follow certain precautions while fasting, diabetics have to take extra precautions because their body does not have the ability to control fluctuations in blood sugar level.

 They also dehydrate faster especially when their sugar levels rise, therefore they need to ensure they take sufficient precautions to maintain their sugar levels while fasting.

 “ The most important step for any diabetic who chooses to fast is to ensure he visits his health practitioner so that the doctor can advise whether it is safe for him to fast and to gauge whether his body will be able to manage long hours of fasting.

Once that is ascertained, the patient needs to modify the medication dosage- usually lower the dosage- to ensure they maintain their sugar levels.”
 
Farooqi added that both rise or drop in the sugar level for diabetics with Type 1 and 2 diabetes can cause serious complications, like loss of consciousness so diabetics have to be extremely careful when fasting.  

A drop in the sugar level can cause several other symptoms such as weakness, shaking of the hands, difficulty in speech, heart palpitations etc.

This situation occurs due to low sugar and excess insulin in the body.

This can happen in both type and type 2 diabetes.

' It is important for diabetics to carry a sugar source with them at all times and if they experience these symptoms, they should immediately take the sugar source and contact their doctor or emergency services depending on the urgency of the situation.

 On the other hand, a condition called Diabetic Ketoacidosis can occur in people with type 1 diabetes when there is no insulin in the body.

This happens if the long acting insulin dose is missed and can  also cause the patient to fall into a coma.

Therefore, the insulin should be taken properly and on time. “

Inaam Ibrahim Kandil, Head of Diabetes Education Coordination at the Dubai Diabetes Center, said, “The problem we face is that many diabetics do not realize the complications they can suffer from while fasting if they neglect taking certain precautions while fasting.

Therefore awareness is the key to ensure our patients do not face any health consequences due to fasting and keeping their blood sugar within target range as it was before they began their fasts and not indulge in eating the wrong foods.”

Manal Al Buflasa, Senior Nurse Educator at the Dubai Diabetes Center  emphasized that while diabetics are keen to adhere to the rituals of Ramadan, it is permitted to break the fast when a diabetic goes through any complications while fasting during the day.  

She also highlighted the fact that self monitoring of blood sugar is permitted during fasting and should be effectively utilized to avoid hypoglycaemia.

This should be done as soon as the patient notices any of the associated symptoms of blood sugar fluctuations. 
 
General Guidelines to Keep in Mind:
 
•    DO NOT skip meals (Suhur/Iftar) during Ramadan.
 
•    Enjoy a light meal at Suhur rather than having a meal at midnight – eat wholegrain breads, oatmeal or high-fibre cereals with 1 cup low-fat/fat-free milk and  1 – 2 pieces of fresh fruit.
 
•    At Iftar, eat slowly-absorbed foods such as beans and lentils in addition to lean meat, fish or chicken, milk or yogurt and  consume plenty of vegetables and  a serving of fresh fruit.
 
•    Avoid high-calorie, processed and  salty foods. 
 
•    Limit fried and  fatty foods. Measure the amount of oil used in cooking (use 1–2 tablespoons for a four-person dish).
 
•    Limit intake of sweets and  desserts as mush as possible.
 
•    Try to stay within your carbohydrate budget. 
 
•    Drink enough water and/or sugar-free beverages between Iftar and  Suhur to avoid dehydration, especially at Suhur. 
 
•    Avoid overeating at meals.
 
•    Take your medication and/or insulin as prescribed. 
 
•    Enjoy being physically active after Iftar for at least 30 – 45 minutes on most days of the week! Tarawih prayers are considered as part of the exercise program. 
 
 
Who should NOT fast? 
 
1)    Patients who have had severe low blood glucose 3 months prior to Ramadan.
2)    Patient with a history of recurrent low blood glucose.
3)    Hypoglycemia unawareness.(  diabetic patients with low blood glucose who do not have any symptoms and unfortunately are therefore NOT aware of the hypoglycemia) 
4)    Patient who are NOT controlling their diabetes well, especially those with diabetes Type 1.
5)    Those who had Diabetic Ketoacidosis  3 months prior to Ramadan.
6)    Acute illness such as infections, Flu, etc.
7)    Pregnancy.
8)    Patient on chronic dialysis.