Insulin users cautioned against fasting

Rawalpindi

The diabetics who inject insulin on regular basis to control their blood glucose should not opt for fasting in the holy month of Ramazan as the potential risk of not taking insulin due to fast is much greater to their health for both the short and long term basis.

However, the diabetics who use tablets to control their diabetes and if they have their diabetes under control can fast but only after a careful advice from their physicians.

The diabetics on insulin fall in the third category of the disease and because of being more diabetic, they may suffer serious complications due to a little carelessness while fasting in the month of Ramazan, said Assistant Professor of Medicine (Infectious Diseases) at Rawalpindi Medical College and consultant diabetologist Dr Muhammad Mujeeb Khan while talking to ‘The News’ on Friday.

He added that it is a wrong assumption among public that every diabetic can get benefits from fasting instead it is generally witnessed that most of the diabetics develop complications during Ramazan and it is so because majority of people suffering from diabetes do not consult their physicians before opting for fasting for a month.

He said that to avoid complications, diabetics should opt for fasting after taking proper advice from a qualified physician particularly about their schedule of medicines and selection of food to be taken during Ramazan. “A little carelessness on selection of diet at the time of ‘Iftar’ and ‘Sehr’ may cause serious complications for diabetics even for those who have their diabetes under control.”

To a query, he said medically, fasting is not recommended for the patients falling in third category. Severe diabetic patients may suffer from life threatening complications if opting for fasting without following a proper diet plan, said Dr. Mujeeb.

In a number of cases of diabetes, a physician changes schedule of medicines for the patient going for fasting and it is only possible when the patient informs the physician well in time of his intentions of opting for fasting for a whole month of Ramazan, he explained.

He said diabetics can be divided into three categories on the basis of ways and means they are advised to follow for controlling blood glucose. Patients who control sugar level by adopting life interventions like exercise and walk do not have any complications while fasting; however they should follow doctor’s advice regarding diet.

He added that diabetics who use oral hypoglycaemic medicines (tablets) to control sugar level in their blood can fast only if they have no complications of the disease. Such patients must consult their physicians before going for fasting enabling doctors to change schedule of medicines, said Dr. Mujeeb.

Regular self-monitoring of blood glucose is a must for every diabetic opting for fasting as low blood sugar levels (known as a “hypo”) are dangerous, and may lead to fainting or fits if left untreated. Feeling dizzy, sweaty and disoriented may all suggest a hypo and if a person with diabetes has these symptoms, he or she should immediately break open the fast and has a sugary drink, or place sugar or a sugar-rich sweet below tongue.

Talking of the diet plan for diabetics during Ramazan, Dr. Mujeeb Khan suggested that diabetics should avoid ‘Sharbats’ and sweet substances like ‘Jalebis’ at the time of iftar, as the sweet substances may cause hyperglycaemic peaks (sudden shooting up of sugar level) which is dangerous for patients. “A diabetic may take a little quantity of sweet substances but greater quantity of these certainly causes severe complications.”

He said that at the time of ‘Sehr’, a diabetic should take plain leaf of bread (chapati not paratha) preferably with yogurt, milk, vegetable curry, pulses or egg however he should avoid jams and marmalade.

He said a diabetic going for fasting may add food with high protein including fish, meat, chicken, pulses and eggs to his diet plan but after taking advice from a physician.