Rawalpindi : Patients with diabetes can have both short and long-term effects on health if they do not follow a proper plan while fasting in Ramazan and the patients with wild blood sugar fluctuations must consult qualified physician if want to opt for fasting.
Wild blood sugar fluctuations means 300 milligrams per decilitre one day and 50 mg/dL the next day may make a diabetic unable to fast because a diabetic cannot risk lowering blood sugar too much or getting it much higher as the conditions can seriously affect his or her health. However, the diabetics with well-controlled diabetes have less or no health risk from fasting.
Diabetologist Dr. Muhammad Mujeeb Khan who is also Head of Department of Infectious Diseases at Holy Family Hospital expressed this while talking to ‘The News’ on Thursday.
He added that pregnant women with a history of hypoglycaemia (low blood sugar) and patients with a history of a diabetes complication called ketoacidosis should not fast without prior consultation with their physicians.
Medically, in diabetic ketoacidosis, the blood becomes highly acidic as a result of dehydration and excessive ketone (acid) production and the serious condition can make a patient violently ill and can cause death.
Dr. Mujeeb said that patients while fasting with persistently uncontrolled diabetes may have both short and long-term adverse effects on health. In such patients, the HbA1c level increases that is predictive of associated complications of both short and long-term nature. Such patients may also suffer from metabolic disorders, he said.
It is important that diabetics who use insulin stop using it during a fast that may be applicable for some patients with Type 2 diabetes, but for Type 1, life of a patient mostly depends on it, and one cannot stop basal insulin. In Type 1 diabetes, the body does not produce insulin while in Type 2, the pancreas usually produces some insulin.
Studies reveal that the risk for hypoglycaemia (lowering of blood sugar) is 4.7 times greater than normal during fasting in those with Type 1 diabetes and 7.5 times greater than normal in those with Type 2 diabetes.
To a query, Dr. Mujeeb said the patients with persistent high blood sugar while fasting in Ramazan may suffer from episodes of severe dehydration and the condition may lead of renal failure even after Ramazan. Fasting in such patients may cause damage to kidneys, he said.
He added the patients who do not have well-controlled diabetes no matter they have Type 1 or Type 2 diabetes should not fast particularly without consulting qualified physician.
He said lowering of blood sugar is a greater concern while fasting but high blood sugar can also occur and it is frequent monitoring that reduces the risk of both hypoglycaemia and hyperglycaemia (high blood sugar).
Most people with diabetes while fasting should limit the physical activities during the evening hours when risk for low blood sugar can rise, he added.
Diabetics should eat a healthy meal at ‘sehar’ having some complex carbohydrates (found in foods such as peas, beans, whole grains, and vegetables) and high fibre and should drink plenty of fluids, he said.
At ‘iftar’, a balanced meal that combines protein, fibre and healthy carbohydrates can help keep your body and blood sugar in balance, said Dr. Mujeeb. Finally, he said the diabetic cases are considered unique in nature so every diabetic should have an advice from his or her physician before going for fasting.