Managing Diabetes in Ramzan..!!
Ramzan is the most awaited time for people belonging to muslim community. It is a lunar based holy month, duration of which varies between 29-30 days and involves fasting for more than 18 hours a day. Those who fast abstain from eating, drinking and use of oral medications from pre-dawn to after sunset, which is not intended to create hardship on an individual as per the religious tenets. Fasting for so many hours with diabetes (especially with type-I diabetes) is a medical challenge for an individual itself and their health care providers.
This blog brings to you simple yet effective measures of managing diabetes during this holy period.
Anticipatory health check
Visit your diabetes consultant at the start of ramzan with specific attention to glycaemic control, steady blood pressure levels and lipid profile. For those with diabetes type – I, a closer contact with the physician and dietitian is advisable.
Begin ‘Roza’ the right away
‘Sehri’ or the ‘pre-dawn’ meal after which fast begins should be based on ‘Indian-thali’ concept; whole grains, whole pulses, cooked/raw vegetables and curds..., non-veg. recipies should be included in grilled, roasted, curry or baked forms. Any form of deep fried dishes should be avoided. The ideal time to take pre-dawn meal would be just before the start of daily fast.
Calling it off even better
‘Iftaari’ or the ‘after-sunset’ meal should ideally be kept light..., like a commonly taken breakfast. The traditionally consumed dates and fresh fruits can be coupled with some cereal and milk serving to initiate on a steady glycaemic control. It also helps to avoid gastrointestinal symptoms like bloating, hyperacidity and heart burn which one typically experiences after a heavy meal.
Excessive strenuous activity may lead to hypoglycaemia. Moderate activity, however, may be planned. Repeated cycles of kneeling, rising and bowing during prayers should be considered as part of daily exercise program. Young adults with diabetes type-I who follow a regular exercise pattern can plan it post the after-sunset meal, with at least one and half hour difference between the meal and exercise.
A daily fluid intake of 2 litres including tea, coffee, milk, buttermilk etc. should be maintained. Inadequate fluid intake during prolonged fasting, is a cause of dehydration. This dehydration can be severe due to excessive perspiration in hot and humid climate and in those who perform hard physical labour. Taking fluids intermittently between meals after the fast is called off, for every half an hour can help maintain fluid balance and prevent dehydration.
Identifying and managing symptoms
One should be educated to identify symptoms of hypo and hyperglycaemia. Fast should be called off immediately in case of hypoglycaemia that is blood sugar level reaches <60mg/dl or <70mg/dl in first few hours as well as in case of hyperglycaemia when it reaches >300mg/dl. Blood glucose values should be checked frequently to avoid any emergency situation.
A patients’ decision to fast should be made after a detailed discussion with the health care provider. The ones who insist on fasting must undergo proper assessment and receive adequate education and instructions regarding menu planning, glucose monitoring, timing of medications and managing acute glycaemic responses. Any day..., a patients’ individual awareness and willingness to maintain a sound health status while practising religious beliefs holds utmost importance.
By Pooja Lakhani Health Coach at LNF Content verified content by Dr Anjali Hooda