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Do Diabetics Have To Fast During Ramadan?

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 >>

Ramadan And Diabetes

Ramadan And Diabetes

Fasting during the holy month of Ramadan is an important spiritual practice. When you have diabetes, you may be wondering how fasting will affect your diabetes. There is a lot of misinformation about diabetes and Ramadan. This handout is written to answer some of the most common questions. Does everyone have to fast? No. This is based on the Holy Quran as well as the teachings of Islamic religious scholars over centuries. The Quran states that there are groups of people who do not have to fast, especially if it puts their health at risk. This includes children, pregnant or breastfeeding women, the elderly and anyone who might make themselves ill by fasting. This also includes people with poorly controlled diabetes, people with type 1 diabetes who take insulin or type 2 on a mixed insulin regimen or those who often have very high or very low blood glucose levels. I know many people with diabetes who fast and don’t have a problem. Is it okay for me? It is true, many people with diabetes can fast safely, but each person is different. Part of the decision you will make with your doctor has to do with the kind of diabetes medicine you take. It is important to schedule an appointment 2-3 months before Ramadan to discuss how fasting might affect your diabetes. Your doctor or healthcare provider may suggest a change in your medication plan. What risks should I be aware of? These are the key risks: • Low blood glucose (or hypoglycemia) – The risk of blood glucose levels going too low is highest in people taking insulin or certain diabetes pills. Limit physical activity during fasting hours and be more active after sunset. Talk with your healthcare provider to find out if your medicine puts you at risk for low blood glucose and discuss how to prevent it. • High blood gluc 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 >>

Safe Fasting For Diabetics During Ramadan

Safe Fasting For Diabetics During Ramadan

Safe fasting for diabetics during Ramadan The month-long Islamic religious festival, Ramadan, when observant Muslims fast during daylight hours, is about to begin around the world but fasting can be extremely dangerous for diabetics. Despite the fact that diabetics are not required to fast during Ramadan and that there are serious health risks involved, many choose to do so anyway. A study published in Diabetes Care suggests that as many as 43% of Muslim type 1 diabetics and and 79% of Muslim type 2 diabetics participate in the fast each year. Health24's resident diabetes expert, endocrinologist Dr. Wayne May suggests that type 1 diabetics should never fast."Generally we will advise against fasting for type 1s but there are type 2s who can fast, e.g. patients on oral tablets, or who are on basal insulins only. Those on basal bolus or mixed insulins twice a day will need to check with their doctors. Patients with end organ complications like kidney failure also shouldnt fast, as they are at increased risk of hypoglycaemia." Fasting can put diabetics, especially those with type 1 at risk of low blood sugar ( hypoglycaemia ), a serious medical emergency that can result in seizures, coma and even death if not treated urgently. Hypoglycaemia is particularly dangerous when a diabetic lacks "hypo" awareness. This means that they do not experience symptoms of low blood sugar such as dizziness, rapid heart rate, sweating and confusion. Without these important warning signs, a hypoglycaemic diabetic is at a far greater risk of complications associated with dangerously low blood glucose. For those who battle with high blood sugar ( hyperglycaemia ), a lack of water can lead to dehydration and extended high blood sugar may result in diabetic ketoacidosis , a life-threatening condi Continue reading >>

Recommendations For Management Of Diabetes During Ramadan

Recommendations For Management Of Diabetes During Ramadan

Since our last publication about diabetes and fasting during Ramadan (1), we have received many inquires and comments concerning important issues that were not discussed in the previous document, including the voluntary 1- to 2-day fasts per week that many Muslims practice throughout the year, as well as the effect of prolonged fasting (more than 18 h a day) in regions far from the equator during Ramadan when it occurs in summer—a phenomenon expected to affect millions worldwide for the next 10–15 years. Since 2005, there have been substantial additions to the literature, including two studies examining the effect of structured education and support for safe fasting, both of which had promising results (2,3). In addition, new medications, such as the incretin-based therapies, have been introduced with less risk for hypoglycemia. According to a 2009 demographic study, Islam has 1.57 billion adherents, making up 23% of the world population of 6.8 billion, and is growing by ∼3% per year (4). Fasting during Ramadan, a holy month of Islam, is a duty for all healthy adult Muslims. The high global prevalence of type 2 diabetes—6.6% among adults age 20–79 years (5)—coupled with the results of the population-based Epidemiology of Diabetes and Ramadan 1422/2001 (EPIDIAR) study, which demonstrated among 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 (6), lead to the estimate that worldwide more than 50 million people with diabetes fast during Ramadan. Ramadan is a lunar-based month, and its duration varies between 29 and 30 days. Muslims who fast during Ramadan must abstain from eating, drinking, use of oral medications, and smoking from predawn to after Continue reading >>

Tips For Diabetics Who Plan To Fast During Ramadan

Tips For Diabetics Who Plan To Fast During Ramadan

Dr Farhana bin Lootah offers crucial advice to those who are fasting during the holy month from an internal medicine specialist at Imperial College London Diabetes Centre. Can I fast during Ramadan if I have diabetes? For most people, fasting is not harmful. However, a problem can occur if you are living with diabetes, such as the risk of high glucose levels following the larger meals that we eat before and after fasting at suhoor and iftar. Of course, this year the fasting period is long – 15 hours in the UAE – meaning that the risks of hyperglycaemia (high blood sugar levels) and dehydration (lack of water) are high. It is also important to not break the fast with a very large, excessive meal as there is a potential risk of post-meal hyperglycaemia. Distribute energy intake from food over two to three smaller meals during the non-fasting interval. This may help you avoid this spike in blood sugar. It is very important that anyone living with type 1 diabetes understands that they are at a higher risk compared to those with type 2 diabetes when fasting during the holy month. It is recommended that anyone living with diabetes consults with their doctor before fasting. It is crucial that if you are a type 1 diabetes patient and intend to fast, that you are closely supervised. And ensure that your blood sugar is regularly monitored to mitigate health risks, where together you will look to adjust insulin doses according to food intake and activity. If you are living with type 2 diabetes, generally it is safe to fast during Ramadan, provided that you talk to your doctor about your plans and prepare yourself well. But it is not safe for everyone living with type 2, especially those who have poorly controlled diabetes. Your ability to fast safely is often influenced by you Continue reading >>

Ramadan And Diabetes: Guide To Diabetes Management During Ramadan

Ramadan And Diabetes: Guide To Diabetes Management During Ramadan

Ramadan is a lunar month, which is coming in a few weeks as I am writing this article. During this month Muslims fast by avoiding any kind of eating or drinking as well as medications or smoking for certain hours every day. Fasting has many effects on the body and its physiology, which requires good understanding of these changes and the effect they have on diabetic patients. According to the EPIDIAR(Epidemiology of Diabetes and Ramadan) study on 12,243 Muslims from 13 different countries, approximately 43% of Type 1 Diabetes patients and 79% of Type 2 Diabetes patients fast every year during Ramadan. Diabetes and Ramadan Guidelines In this article we will go through the changes in the body and pathophysiology of the body during Ramadan, as well as the changes and guidelines that should be taken into consideration by diabetic patients during the month of Ramadan. Pathophysiology of Fasting In healthy individuals, feeding promotes the secretion of insulin (a hormone secreted from the pancreas), which is responsible for the storage of glucose sugar in muscles and liver as glycogen. Levels of Insulin tend to decrease during fasting as a result of the decreased glucose levels. On the other hand, levels of catecholamines and glucagon are increased, which stimulates glycogen degradation. After several hours of fasting, the stores of glycogen are depleted, and increased levels of fatty acid are released from fat cells as a result of the low circulating levels of insulin. According to a study by Felig, the transition from a fed state to a fasted state is mediated by several hormonal, glucoregulatory, and metabolic mechanisms, which can be divided into three stages: Postabsorptive phase, which lasts from 6 to 24 hours after the beginning of fasting Gluconeogenic phase, which las 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 >>

Fasting During Ramadan

Fasting During Ramadan

Because we are Muslim, every year for one month my family observes the fast for Ramadan. Fasting occurs from dawn until sunset; any time before and after we can eat as normal. I’ve been fasting for the month for as long as I can remember. When I was really young, I of course didn’t have to fast, but my twin brother, my cousin (who is also my age), and I would try our best to fast even when our parents told us we didn’t have to. It was sort of a challenge for each one of us. We started out by fasting half days, but eventually graduated to fasting the entire time. As a kid, fasting was never a real concern because up until age 10, I didn’t have diabetes. Once diagnosed, however, one of my biggest concerns was that I wouldn’t be able to fast. I know for a lot of people, especially young kids, getting diabetes would be the PERFECT out for not having to fast. For me though, it was the opposite. Growing up, and to this day, Ramadan is always my favorite month out of the year. It’s about much more than simply abstaining from food and water. The month focuses heavily on gaining a stronger sense of spirituality, as well as working to improve yourself in general. My fondest memories are smelling my mom’s delicious cooking while we’d count down the minutes until we could break our fast. (Now I’m responsible for helping out in the kitchen, and let me say, huge props to the moms cooking during Ramadan. It’s hard to be in the kitchen and not able to eat anything!) I always loved how packed the mosque would be during Ramadan because the community would come out for the night prayer called taraweeh. When diagnosed, I was afraid that the month would lose it’s “magic” because I wouldn’t be able to fast. Luckily enough, I was diagnosed in December (which nine y Continue reading >>

Ramadan Fasting Can Be Dangerous For Muslim Diabetics…but A New Website Helps

Ramadan Fasting Can Be Dangerous For Muslim Diabetics…but A New Website Helps

As Muslims head into Ramadan—a month-long period of religious fasting that begins Saturday, May 27th —medical experts caution diabetics and their doctors to be aware of the dangers of fasting and to utilize a Web-based tool that helps them follow fasting rituals safely. “There are 1.6 billion Muslims in the world and 148 million have diabetes, and that number is growing at a faster pace than in non-Muslims,” says Osama Hamdy, MD, Medical Director of the Obesity Clinical Program and Director of the Inpatient Program at the Joslin Diabetes Center, Harvard Medical School, who presented research on Ramadan fasting and diabetes at the American Association of Clinical Endocrinologists conference in Austin on May 4th. (In the U.S., there are about 3.3 million Muslims. 1 The effects of fasting during Ramadan—which requires no food or fluids from sunup to sundown—can include dehydration, hypoglycemia during fasting hours, and hyperglycemia after the big meal at the end of the day. “Some of the large, end-of-day meals, which may be eaten quickly because of hunger, can be as high as 1500 calories and usually includes sugary desserts specific to Ramadan,” he adds. The risk of diabetic ketoacidosis —when the body builds up ketones causing weakness, confusion, vomiting (it can be fatal) is 4 to 5 times higher during fasting in patients with type 1 diabetes, says Dr. Hamdy. Ramadan follows the lunar calendar, and thus occurs 11 days earlier every year. Because Ramadan falls during hot weather for several years in a row, it can increase the risk of dehydration. In fact, summer fasting periods can last up to 20 hours per day. “Many physicians will tell their diabetic patients not to fast, but data shows 2 that 94% of those with type 2 diabetes will fast for at least Continue reading >>

Safe Fasting With Diabetes

Safe Fasting With Diabetes

Whether you are honoring an ancient religious practice or heading to the lab for a fasting blood test, care is needed when missing meals with diabetes. Fasting can throw off the delicate balance of food, water, and blood glucose levels in potentially harmful ways. Fasting with diabetes poses significant risks, says Kathaleen Briggs Early, PhD, RD, CDE, of the Pacific Northwest University of Health Sciences. Most of the research on fasting and diabetes surrounds Ramadan, the annual Islamic observance that requires fasting from sunrise to sundown for 29 or 30 days. A commentary published in 2010 in Diabetes Care developed in collaboration with the American Diabetes Association (ADA) focused on fasting during Ramadan, though many of the issues it raises are relevant to other types of fasting as well. It says that “most often, the medical recommendation will be not to undertake fasting” if you have diabetes. The paper acknowledges that fasting for spiritual reasons is a personal decision, but one that should include the guidance of a health care provider. A study found that 43 percent of people with type 1 diabetes and 79 percent of people with type 2 diabetes from 13 Islamic countries fast during Ramadan. With that reality, fasting safely becomes a priority for people with diabetes and their care providers. “Anybody with diabetes needs to first talk to their doctor about going on a fast,” says Early, and some experts recommend a pre-fasting medical assessment to help ensure safety. If you are considering fasting, talk to your health care provider about a plan that takes medication, nutrition, and hydration into account. Regularly monitoring blood glucose during fasting is key to avoiding health emergencies. Not eating when taking insulin or certain other diabetes Continue reading >>

Fasting During Ramadan: The Health Risks For Diabetics

Fasting During Ramadan: The Health Risks For Diabetics

A Pakistani Muslim man arranges Iftar food for Muslim devotees before they break their fast during the holy fasting month of Ramadan in Karachi Fasting during Ramadan: the health risks for diabetics Dr Neesha Patel carried out the UK's first study on the experiences of Muslims with diabetes during Ramadan. Here, she answers questions about the practice, and the health implications What does the act of fasting during Ramadan represent in Islam? Ramadan is important for practicing Muslims, as it is one of the five pillars of Islam and the month in which the holy Quran was revealed. During Ramadan, Muslim people only eat two meals per day, once before sunrise (sehar) and one after sunset (iftar). Sharing the full story, not just the headlines The Islamic law states that the sick can be exempt from fasting for one or all 30 days and give money to the poor, but some Muslims with diabetes may not perceive themselves as being sick and will choose to fast. A tension will often exist among Muslims with diabetes who wish to observe Ramadan in accordance with their faith and the competing need to manage their health. This was evident in my recent research, which was the UK's first study on the beliefs and experiences of Muslims with diabetes during Ramadan. Fasting during Ramadan is a spiritual time that is believed to teach morals, self-discipline and a time for reflecting on ones relationship with Allah and fellow people. Currently there are no national guidelines on the benefits of fasting for people with diabetes but there is some evidence to suggest that fasting may be beneficial to health in the general population. As Ramadan currently falls in the summer and spring months, and will do for the next eight years, daylight lasts between 17 and 19 hours, thus increasing the num Continue reading >>

1319: Ruling On Fasting For One Who Is Diabetic, And When Is It Permissible For Him Not To Fast?

1319: Ruling On Fasting For One Who Is Diabetic, And When Is It Permissible For Him Not To Fast?

I have diabetes typeII wich is NIDM non insuline depend diabetes, I don't use any medicine, I only controll diet and I do litle phisical exercise to keep in right level of my sugar(blood). I have this decease one year and two monhts. Last Ramadan I fasted some days but I could n't continue do to my low level of sugar(blood). This year I feel good (Alhamdu Lillah)I ONLY feel pain in my brain during fasting!? So my question is, is it my DUTY to fast dispite my desease? Can test my blood during fasting times; "causing blood to come from my fingers"? Praise be to Allaah. It is prescribed for sick people not to fast in Ramadaan, if fasting will cause harm or make the sickness worse, or if they need treatment during the day in the form of medicine or pills that must be swallowed, because Allaah says (interpretation of the meaning): “and whoever is ill or on a journey, the same number [of days which one did not observe Sawm (fasts) must be made up] from other days”[al-Baqarah 2:185] And the Prophet (peace and blessings of Allaah be upon him) said: “Allaah loves people to avail themselves of His concessions (rukhsah) just as He hates them to commit sin.” According to another version, “As He loves His commands to be obeyed.” With regard to taking blood from veins for testing etc., the correct view is that this does not break the fast, but if it is done often, it is better to leave it until night-time. If it is done during the day then to be on the safe side that day should be made up, because this is akin to cupping.” (Fatwa of Shaykh Ibn Baaz (may Allaah have mercy on him), from Fataawa Islamiyyah, vol. 2, p. 139) Sickness is of various kinds: 1 – That which does not affect the fast, such as a light cold or mild headache or toothache, and the like. In this case 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 >>

Managing Diabetes During Ramadan Is All About Smart Management And Making Healthy Choices. Some Interesting Information To Note:

Managing Diabetes During Ramadan Is All About Smart Management And Making Healthy Choices. Some Interesting Information To Note:

If you are planning to fast and you have diabetes, it is important to speak to your diabetes healthcare team as early as possible before Ramadan begins. For some people with diabetes, fasting can be dangerous. Your diabetes team will be able to advise you on whether it is safe for you to fast. If you are able to fast, they will advise you on how to manage your condition throughout the fasting period. Possible Complications of Fasting during Ramadan Fasting among patients with type 1 diabetes, and among those with type 2 diabetes who have inadequately managed blood glucose levels, is associated with multiple risks. Some of the major potential diabetes-related complications of fasting include dangerously low blood glucose (hypoglycemia), excessively high blood glucose (hyperglycemia), diabetic ketoacidosis and thrombosis (blood clots). Hypoglycemia and Hyperglycemia Hypoglycemia is the fall of blood sugar under the normal levels (less than 70mg/dl – 3.9mmol/l). Hyperglycemia is the rise of blood sugar above normal levels (above 200 mg/dl – 11.1 mmol/l) which may lead to diabetic Ketoacidosis in type 1 diabetes patients. Diabetic Ketoacidosis When the body’s cells don’t get enough glucose, it starts to burn fat for energy. When the body burns fat instead of glucose it causes waste products called ketones. Ketones can make the blood acidic and this can be dangerous. The risk for diabetic ketoacidosis may be further increased due to excessive reduction of insulin – based on the assumption that food intake is reduced during the month. Patients with type 1 diabetes who choose to fast during Ramadan are at a higher risk of developing ketoacidosis, especially if they have been experiencing hyperglycemia frequently before Ramadan. Dehydration and Thrombosis Fasting duri Continue reading >>

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