diabetestalk.net

Diabetes And Fasting During Ramadan

Diabetes And Fasting During Ramadan

Diabetes And Fasting During Ramadan

Abstract Abstinence from food and liquid during daylight hours is observed by Muslim individuals during the month of Ramadan. Even though the Koran exempts the sick from fasting, many people with diabetes still fast during this religious period. It is essential for patients, family and healthcare professionals to be aware of the religious attitude to and health implications of fasting. Major changes in dietary habits, daily physical activities and sleeping patterns during Ramadan have significant impact on the glycaemic control, lipid profile, weight and dietary intake. Hence, the patient is encouraged to have appropriate pre-Ramadan assessment and education in order to stratify and modify his or her risk with fasting. Dose and timing adjustments to insulin and to some oral hypoglycaemic agents, especially sulphonylureas, may well be necessary during Ramadan. Copyright © 2010 John Wiley & Sons, Ltd. Introduction Ramadan is the ninth month of the Islamic calendar, when Muslims fast during daylight hours. It is based on a lunar calendar; therefore, the duration of daily fast and the overall period of the month of Ramadan vary each year depending on the geographical location and season. Two main meals are usually consumed during Ramadan, before sunrise, known in Arabic as ‘Sohur’, and after sunset, known as ‘Iftar’. Changes in meal frequency, daily physical activities and sleeping patterns during Ramadan may influence the glycaemic and other biochemical parameters in patients with diabetes 1–3. Although the Koran exempts sick people from fasting, many Muslims with diabetes may not perceive themselves as sick and choose to fast, despite medical advice to the contrary. Effects of fasting on lipid profile and weight Caloric intake Even though people abstain from an Continue reading >>

Fasting During Ramadan Poses Unique Risks For Those With Type 2 Diabetes

Fasting During Ramadan Poses Unique Risks For Those With Type 2 Diabetes

(Reuters Health) - Muslims with type 2 diabetes who choose to fast during Ramadan may benefit from individualized education programs, according to findings presented this month at the annual meeting of the American Diabetes Association (ADA) in Boston. Ramadan is the ninth month of the Muslim (lunar) calendar, when the Quran was first revealed to Muhammed, according to Islamic doctrine. The month is calculated to begin this year on June 18 in most countries. Muslims around the world observe Ramadan by fasting from dawn until sunset. While people with diabetes are exempted from fasting under Islamic law, many still choose to do so, said Dr. Mahmoud Ibrahim, an endocrinologist and the director of the Diabetes Education Center in McDonough, Georgia. “Our mission is not to ignore them but trying to help them achieve safer fasting as much as we can,” he said in a telephone interview. According to Ibrahim, fasting during Ramadan poses two types of risk to people with type 2 diabetes, sometimes called adult-onset diabetes. First are complications such as low blood sugar, high blood sugar, ketoacidosis (a metabolic imbalance that can be fatal), dehydration, and blood clots. Second, Muslims who observe Ramadan often feast after breaking their fast, which can lead to weight gain. “The decision to fast is actually an interplay between three major players-the person himself, his religious leader, and the medical advisor,” Ibrahim said. “All people with type 1 diabetes or who need insulin should not fast, any underaged child should not fast, and of course any women who are diabetic and pregnant should not fast at all.” The ADA recommends that people with type 2 diabetes who choose to fast during Ramadan receive education on how to achieve a safer fast. At the ADA meeting Continue reading >>

Should Type 1 Diabetics Fast In Ramadan

Should Type 1 Diabetics Fast In Ramadan

Fauzia Mohsin,Kishwar Azad,Abdul Baki,Nazmun Nahar ( Department of Paediatrics, BIRDEM General Hospital and Ibrahim Medical College, Dhaka, Bangladesh. ) Bedowra Zabeen,Samin Tayyeb ( Changing Diabetes in Children (CDiC), BIRDEM General Hospital, Dhaka, Bangladesh. ) Read PDF May, 2015 Abstract Fasting during the holy month of Ramadan is obligatory for all healthy adult and adolescent Muslims from the age of 12 years. This involves abstaining from eating or drinking from early dawn (Suhur/Sehri) till sunset (Iftar).Fasting is not meant to create excessive hardships or impart any adverse effect to the Muslim individual. As such, Islam has exempted certain categories of people from fasting including young children, travelers, the sick, the elderly,and pregnant and lactating women. According to expert opinion, people with type 1 diabetes who fast during Ramadan are at very high risk of metabolic deterioration. However, some recent studies have demonstrated that individuals with type 1 diabetes who are otherwise healthy and stable, can fast during Ramadan provided they comply with the Ramadan focused management plan and are under close professional supervision. This article discusses how to assess, counsel, monitor and manage people with type 1 diabetes who wish to fast during Ramadan. Keywords: Ramadan, fasting, Type 1diabetes. Introduction Fasting during the holy month of Ramadan, one of the five pillars of Islam, is obligatory for all healthy adult and adolescent Muslims from the age of 12 years. The month has huge spiritual implications and is an opportunity to purify ourselves. Along with refraining from all sorts of sins and misdeeds, one has to abstain from eating or drinking from early dawn (Suhur/Sehri) till sunset (Iftar) each day-approximately 11-20 hours, depend Continue reading >>

Ramadan And Diabetes

Ramadan And Diabetes

Tweet There is often discussion about whether people with diabetes should fast during Ramadan or not. Ramadan is a month long period of fasting during the daylight hours. Fasting during Ramadan is undertaken to promote chastity and humility and as an act of submission to Allah. Ramadan takes place on the 9th lunar month of the Islamic calendar. As a result, the date varies amongst the western (Gregorian) calendar. Is fasting with diabetes dangerous to health? Fasting during Ramadan could compromise one’s health. Those on blood glucose lowering medication should consult their GP about whether it will be safe for them to fast and what precautions can be taken to prevent blood glucose levels from going either too low or too high. Continuing to take blood glucose lowering medication during the daylight hours of fasting may present a particular risk of low blood glucose; hypoglycemia. During the hours of night, when the day’s fast can be broken, the body may need to take in more food than would normally be eaten, as a result, this may lead to higher blood glucose levels during the night time hours. Should people with diabetes fast during Ramadan? People are recommended not to fast if the act of fasting could negatively affect their health. The charity, Diabetes UK, advises people with existing diabetic complications not too fast. People with type 1 diabetes should not stop taking their insulin as this could lead to a dangerous condition called diabetic ketoacidosis. However, fasting whilst continuing to take insulin could lead to hypos so people with type 1 should seek the advice of their consultant or diabetologist before taking part in fasting. Other people which may be exempt from fasting include pregnant women, the elderly and those suffering an illness. Those who ca Continue reading >>

Caring For Muslim Patients Who Fast During Ramadan

Caring For Muslim Patients Who Fast During Ramadan

Commentary Ramadan is a holy month during which Muslims fast from eating, drinking, sexual intercourse, smoking, and all vices from dawn until sunset.1,2 The fast of Ramadan is one of the five pillars of Islam. It is an obligation for all healthy adult Muslims, with a focus on spiritual and physical well-being to strengthen one's relationship with God. Because it is based on a lunar calendar, the dates of Ramadan vary each year. In 2015, Ramadan is expected to occur from June 18 to July 17. VULNERABLE GROUPS WHO OBSERVE FASTING The Quran exempts the sick from fasting.1,2 According to Islamic scholars, persons exempt from fasting include individuals with illnesses that might be exacerbated by fasting (e.g., diabetes), women who are pregnant or breastfeeding, prepubertal children and adolescents, and those on medication regimens that would be affected by fasting. Other groups exempted from fasting include those with disabling mental illness or developmental disabilities, menstruating women, women with postpartum bleeding, older persons, and travelers. Many Muslims who are exempt from fasting nonetheless choose to fast. Clinicians should be able to provide advice on how such patients should safely approach the fast. DIABETES Worldwide, an estimated 40 to 50 million patients with diabetes fast during Ramadan, including nearly one-half of those with type 1 diabetes and most of those with type 2 diabetes.1,3 Patients with diabetes who choose to fast require close blood glucose monitoring because there is an estimated 7.5-fold increase in severe hypoglycemia for those with type 2 diabetes.3 Other risks of fasting with diabetes, particularly when medications are withheld, include hyperglycemia, diabetic ketoacidosis, hyperosmolar hyperglycemic state, dehydration, and deep venou Continue reading >>

Expert Tips: Fasting During Ramadan For Diabetics

Expert Tips: Fasting During Ramadan For Diabetics

Diabetes is a health condition that occurs when sugar rises in the blood as a result of deficiency in the insulin hormone or the resistance of the body cells leading to the accumulation of glucose in the blood. Patients with high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty (polydipsia) and hungry (polyphagia). Diabetic patients who fast during Ramadan are likely to be at risk of major health complications. Hence they should fast only if their doctors consider them fit enough, experts say. The month-long period that is typically marked by long fasting hours during daylight hours is followed by grand feast each evening after sunset (Iftaar), which can be continued till pre-dawn (Sehri). According to health experts, such long gaps between meals that range from 12 to 15 hours may lead to metabolic changes in the body, which can pose serious health problems for diabetes patients. "If you are diabetic but still want to keep the fast during Ramadan, it is always better to consult your doctor to take all necessary precautionary measures while fasting," Vikas Ahluwalia, Director (Diabetes and Obesity Center) at the Max Super Speciality Hospital, Saket, told IANS. Restriction of fluid intake during such fasts can result in dehydration as well as fluctuations in sugar levels. "Long fasting, combined with food intake two-three times over a short span of time may cause wide fluctuation in sugar levels," Rakesh Kumar Prasad, Senior Consultant (Department of Endocrinology) at Fortis Hospital, Noida, told IANS. Diabetics while fasting can either face hypoglycemia -- a sudden fall in blood sugar levels -- which can cause seizures and unconsciousness or hyperglycemia -- increase in blood sugar -- which may cause blurry vision Continue reading >>

Advising Patients With Diabetes About Fasting During Ramadan

Advising Patients With Diabetes About Fasting During Ramadan

Fasting in the month of Ramadan represents a recurring annual event in the life of a practising Muslim. It is important because it is one of the five Pillars of Islam. Many patients with diabetes will want to take part in this event and nurses with a good understanding of its importance and knowledge of how to manage diabetes can assist in ensuring that this is safely undertaken. Full, instant access to all stories Customised email alerts straight to your inbox 5,000+ practice articles in our clinical archive Online learning units on fundamental aspects of nursing care Speak with a member of the team about providing Nursing Times for your whole team Already have an account? Sign in Continue reading >>

Diabetes And Ramadan – Guidance For Fasting During The Holy Month

Diabetes And Ramadan – Guidance For Fasting During The Holy Month

Reference Number: HEY-167/2016 Departments: Diabetes Translate the page Use the headphones button (bottom left) and then select the globe to change the language of the page. Need some help choosing a language? Please refer to the Browsealoud Supported Voices and Languages resource. Fasting During Ramadan Fasting during Ramadan is one of the five pillars of Islam and many people with diabetes choose to observe this religious duty. This leaflet will provide you with guidance. Healthy Muslims may choose to fast during the Islamic month of Ramadan. It is very important that you are seen by the diabetes team at least 6 to 8 weeks before fasting begins as this would help to ensure that your diabetes is stable. In addition, it would be helpful for your family/relatives to be involved to discuss ways of correcting low blood glucose (‘hypos’) if this happens during the fast. Certain groups of people may be exempt from fasting, for example: Children (under the age of puberty) Elderly and people who are sick People who have a learning disability People who are travelling Pregnant, breastfeeding and menstruating women Anyone who would be putting their health at serious risk, e.g. people who treat their diabetes with insulin or have diabetic complications (damage to their eyes, kidneys or the nerves in their hands and feet) Patients who have Type 1 diabetes (ie who started using insulin early after initial diagnosis of Diabetes) If you do choose to fast, your diabetes team will work with you to try and keep your diabetes stable. Changes to your diet During Ramadan your eating pattern will be different. There are only 2 meals per day, Sehri (early morning) and Iftar (evening). Because of this you may experience large swings in your blood glucose levels because of the long gap bet Continue reading >>

How To Manage Your Diabetes During Ramadan

How To Manage Your Diabetes During Ramadan

For Muslims with diabetes, the fast during Ramadan can present a challenge in day to day management of the condition. In this article, Dr Hala Alsafadi offers tips on staying safe. Rahima Alani For Muslims with diabetes, the fast during Ramadan can present a challenge in day to day management of the condition. In this article, Dr Hala Alsafadi offers tips on staying safe. What happens to your body during fasting? During a fast, at about eight hours after your last meal, your body starts to use energy stores to keep your blood glucose (sugar) levels normal. For most people this is not harmful, but if you have diabetes, your body cannot use the glucose as well as it should. With diabetes – especially if you take certain tablets or insulin – you are at risk of hypoglycaemia (low blood glucose levels). Another challenge that can occur if you have diabetes, is the risk of high sugars following the larger meals that you eat before and after fasting (at sehri and iftar), which can lead to health problems in the short and long term. Understanding the risks Your diabetes nurse or doctor will be able to assess the risks associated with fasting and recommend changes to the type, dose and timing of your medication to keep you safe during the fast. It is important to realise that care is highly individualised and that the management plan will differ for each specific person. Fasting is not recommended in the following situations: Type 1 diabetes; Frequent hypoglycaemia or hypo unawareness (i.e. not being aware of it when you're having low blood sugar); Diabetic ketoacidosis within the past six months; Hospital admission for very high blood glucose within the last six months; Severe hypoglycaemia (low blood glucose) in the past six months; If you have poor control of your diabete Continue reading >>

What Diabetics Should Keep In Mind While Fasting During Ramadan

What Diabetics Should Keep In Mind While Fasting During Ramadan

The first rule: One should observe the fast if and only if one is in good health. Observed during the ninth month of the Muslim lunar calendar, Ramadan is considered the holiest month for Muslims. Muslims across the world fast from dawn till dusk during this period. Every year, during this time, they are expected to wake up early and eat a pre-dawn meal (suhoor). The period of fasting that follows involves abstinence from drinking, eating, immoral acts and anger. The fast is broken after sunset with an elaborate feast, referred to as iftar. This year, Ramadan will be observed from May 26 to June 24, 2017. Despite being a holy festival, it is important for people to keep in mind that fasting might also have an adverse affect on one's health. This is of major concern, especially for those suffering from diabetes. The festival of Ramadan involves a prolonged period of fasting. This results in a drastic fall in the blood-sugar level or hypoglycemia. Again, the heavy intake of sweetmeats and other eatables during iftaar leads to a sudden upsurge of sugar or hyperglycemia. Lack of water also dehydrates the body, leading to greater illnesses during the summer season. Diabetics, therefore, have to take certain precautions if they are fasting during Ramadan. Dr Shehla Shaikh, consulting endocrinologist, Wockhardt Hospital, Mumbai, has listed a few important measures that need to be undertaken before one starts fasting. In the first place, patients are advised to consult their doctor at frequent intervals, for six to eight weeks prior to Ramadan. There is also a provision for adjusting one's medication, especially for the festival. Someone who takes multiple doses of insulin should avoid fasting. A patient should fast only when he or she is certified as fit by the doctor. Before Continue reading >>

Guidelines

Guidelines

There is now extensive evidence on the optimal management of diabetes, offering the opportunity of improving the immediate and long-term quality of life of those living with the condition. Unfortunately such optimal management is not reaching many, perhaps the majority, of the people who could benefit. Reasons include the size and complexity of the evidence-base, and the complexity of diabetes care itself. One result is a lack of proven cost-effective resources for diabetes care. Another result is diversity of standards of clinical practice. Guidelines are part of the process which seeks to address those problems. IDF has produced a series of guidelines on different aspects of diabetes management, prevention and care. Diabetes and Ramadan: Practical Guidelines Ensuring the optimal care of the many people with diabetes who fast during Ramadan is crucial. The International Diabetes Federation (IDF) and the Diabetes and Ramadan (DAR) International Alliance have therefore come together to deliver comprehensive guidance on this subject. The IDF-DAR Practical Guidelines provide healthcare professionals (HCPs) with relevant background information and practical recommendations to enable them to help people with diabetes participate in fasting during Ramadan while minimising the risk of complications. Download Continue reading >>

Diabetes Control During Ramadan Fasting

Diabetes Control During Ramadan Fasting

An estimated 50 million patients with diabetes worldwide practice daily fasting during Ramadan, the ninth month of the Islamic calendar, which lasts 29 or 30 days. In the United States, Ramadan begins this year at sundown on Friday, May 26, and ends at sundown on Sunday, June 25. According to the Multi-Country Retrospective Observational Study of the Management and Outcomes of Patients With Diabetes During Ramadan, conducted in 13 countries, 94.2% of Muslim diabetic patients fasted at least 15 days, and 67.6% of these fasted every day.1 The daily fasting period, which may extend from 14 to 18 hours, starts before sunrise and ends after sunset. The meal taken before sunrise is called Suhur, and the meal after sunset is called Iftar. The fast requires abstaining from eating, drinking, sexual activity, medications, and smoking. For diabetic patients, this poses medical challenges, increasing the risk of acute metabolic complications. The goal of caring for diabetic patients during Ramadan fasting is to help them to fast without major complications and to empower them to modify their lifestyle in order to achieve this goal. POSSIBLE METABOLIC COMPLICATIONS Metabolic complications during Ramadan fasting include hypoglycemia, hyperglycemia, diabetic ketoacidosis, dehydration, and thrombosis. For patients with type 1 diabetes, fasting increases the risk of hypoglycemia 4.7 times, and the risk is 7.5 times higher for patients with type 2 diabetes.2 However, this is often underreported, as mild to moderate hypoglycemia does not usually require medical assistance. Precipitating factors include long fasting hours, missing the Suhur meal, and failure to modify drug dosage and timing. The risk of severe hyperglycemia during fasting is 3.2 times higher in patients with type 1 diabete Continue reading >>

How Diabetics Handle Fasting For The Muslim Holy Month Of Ramadan

How Diabetics Handle Fasting For The Muslim Holy Month Of Ramadan

As more than a billion Muslims begin the observation this week of the holy month of Ramadan, Wael Mousfar will be among them. Mousfar, 62, is a Type 2 diabetic, so marking the holy month with the customary fasting during daylight can play havoc with his blood sugar and insulin levels. But Mousfar said he’s not worried. “I will be fasting for sure,” he told ABC News. “I’ve been doing it all my all life. I would not stop during Ramadan, the fast.” Mousfar, of New York City, has been a diabetic for over 20 years, but said his diabetes hasn’t stopped him from observing Ramadan. “I really look at fasting as [spiritual,]” Mousfar said. “It’s body and soul work together.” In previous years, Mousfar said his doctor found that he lost weight and had better blood sugar following the fast. But even in his own family fasting for Ramadan can cause problems. His brother, also a diabetic, has had his blood sugar drop below safe levels during Ramadan and ended up breaking the fast as a result, he said. At the Islamic Center of America in Dearborn, Michigan, Executive Administrator Kassem Allie said diabetes has become a growing concern in the local community. Those who have a medical issue such as diabetes or pregnancy are allowed to break the fast for their health, but Allie said some try to adhere to the rituals anyway. “People are disappointed they can’t fast,” Allie said of those with diabetes. “Some people hesitate to go to the doctor because they say I can’t fast. They try it for a couple days and see how you do.” He explained that many people are reluctant to give up the rituals around Ramadan, including the big meal enjoyed at sunset with family and friends. “They fast for 25 and 30 years and suddenly they develop this malady,” said Allie Continue reading >>

Diabetes And Fasting During Ramadan

Diabetes And Fasting During Ramadan

The 26th of May is the start of most important month of the 2017 Muslim calendar. This month signifies and reaffirms our commitment to Islam and the five pillars which we conform to as Muslims. Islam is a way of life, and fasting is bestowed upon us as soon as we enter puberty until the time of death. As a Muslim, not fasting is a violation of who we are. Sin, guilt, dishonesty and embarrassment are but a few words to describe what most feel when not fasting. The threat of developing complications or even death when fasting with an acute/chronic condition is not sufficient to deter most from fasting. This may result in complications which may have been prevented. Diabetes is a chronic condition which, with education and support, can be managed to prevent complications and obtain a good quality of health. During Ramadan, many factors influence the quality of our fasting day. Maintaining normal blood glucose while fasting is quite a challenge even to the person without diabetes. Late nights with Taraweeh (Ramadan prayers) and early mornings with Suhur (pre-dawn meal) means less sleep. Waking early for Suhur to keep you nourished and satisfied until Iftar (breaking the fast) is a challenge. Mild hypoglycaemia, dehydration, lethargy is the order of the day, to continue for 29 to 30 days of the month. In South Africa, it’s business as usual. Very few companies acknowledge fasting and how difficult it is. Work life is the same as the other 11 months of the year. Expectations to perform continue, which is added pressure while fasting. Possible complications while fasting may be: Hypoglycaemia – While fasting there is no opportunity to correct the hypoglycaemia, which may lead to symptoms including confusion, irritability, coma or hospitalisation if witnessed. The liver pro Continue reading >>

Recommendations For Management Of Diabetes During Ramadan

Recommendations For Management Of Diabetes During Ramadan

It is estimated that there are 1.1–1.5 billion Muslims worldwide, comprising 18–25% of the world population (1,2). Fasting during Ramadan, a holy month of Islam, is an obligatory duty for all healthy adult Muslims. An ∼4.6% prevalence of diabetes worldwide (3) coupled with the results of the population-based Epidemiology of Diabetes and Ramadan 1422/2001 (EPIDIAR) study, which showed (in 12,243 people with diabetes from 13 Islamic countries) that ∼43% of patients with type 1 diabetes and ∼79% of patients with type 2 diabetes fast during Ramadan (4), lead to the estimation that some 40–50 million people with diabetes worldwide fast during Ramadan. Ramadan is a lunar-based month, and its duration varies between 29 and 30 days. Its timing changes with respect to seasons. Depending on the geographical location and season, the duration of the daily fast may range from a few to more than 20 h. Muslims who fast during Ramadan must abstain from eating, drinking, use of oral medications, and smoking from predawn to after sunset; however, there are no restrictions on food or fluid intake between sunset and dawn. Most people consume two meals per day during this month, one after sunset, referred to in Arabic as Iftar (breaking of the fast meal), and the other before dawn, referred to as Suhur (predawn). Fasting is not meant to create excessive hardship on the Muslim individual. The Koran specifically exempts the sick from the duty of fasting (Holy Koran, Al-Bakarah, 183–185), especially if fasting might lead to harmful consequences for the individual. Patients with diabetes fall under this category because their chronic metabolic disorder may place them at high risk for various complications if the pattern and amount of their meal and fluid intake is markedly altered Continue reading >>

More in diabetes