KARACHI: “About 50 million people with diabetes fast during Ramadan worldwide. Recent advancements give us the opportunity to offer diabetic patients a normal or near-normal life. Diabetes Mellitus is a chronic disease. People, fasting with diabetes, are required to have a balanced diet with plenty of fruit, vegetables, and salads, and minimise foods that are high in saturated fats.”
Prof Dr Farhat Bashir, Assistant Dean, Clinical Sciences, at the United Medical and Dental College Karachi, expressed these views while speaking at the online public awareness seminar on “Management of Diabetes in Ramadan” held recently at the Dr Panjwani Center for Molecular Medicine and Drug Research (PCMD), University of Karachi.
Prof Bashir said that the prevalence of type 2 diabetes and prediabetes was much higher in Pakistan. She pointed out that the management of diabetes was quite important for diabetic patients who wish to fast. The major risks of fasting are mainly hypoglycaemia (low blood sugar) and hyperglycaemia (high blood sugar), she said, adding that pre-Ramadan assessment and structured education, including diet advice, self-glucose monitoring, selection of appropriate medication to avoid hypoglycaemia, are quite important for the patient to remain healthy in the holy month.
She advised diabetic patients, who are suffering from other diseases like renal and cardiac diseases, not to observe fasting due to high risk. She asked diabetic patients, who wish to fast, to visit a doctor one or two months before Ramadan, while after Ramadan, they must visit their physicians for a review and adjustment of diet, exercise, and medication.
Talking about exercise in Ramadan, she said that diabetic patients are required to reduce physical activity during the daytime. However, physical exercise can be performed about one hour after Iftar, she said, adding that there is an increase in postprandial physical activity during the night associated with Tarawih.
She advised diabetic patients to consume a balanced diet of a low glycaemic index and included high-fibre foods that release energy slowly before and after fasting. A healthy diet for diabetic patients also includes plenty of fruit, vegetables, salads, multigrain bread, beans, rice, fruit, vegetables, and salads, she said, adding that diabetic patients must avoid sugary desserts and other foods that are high in saturated fats, like ghee, samosas, and pakoras. Patients must consume water or other non-sweetened beverages after Iftar and before Sahar, she said, adding that they are required to avoid caffeinated and sweetened drinks.
Prof Bashir also advised diabetic patients not to avoid monitoring their blood sugar levels. They must check their blood glucose levels whenever they experience symptoms of hypoglycaemia, hyperglycaemia, or feel unwell, and understand when they should immediately break the fast. Individuals who are on insulin need to monitor their glucose more frequently, and this is also mandatory for them to measure blood glucose after Iftar to detect postprandial hyperglycemia, he observed.