Worldwide, around 50 million people with diabetes fast during Ramazan. Pakistan has a high prevalence of both diabetes and pre-diabetes. It is important that patients eat balanced meals suitable for their condition after breaking their fast.
This balanced diet includes lots of fruits, vegetables, salads and beans.
People with diabetes must limit foods that are high in saturated fats such as ghee, samosas and pakoras, said Professor Dr Farhat Bashir, Assistant Dean Clinical Sciences at United Medical and Dental College Karachi at an online seminar held at the Dr Panjwani Center for Molecular Medicine and Drug Research, University of Karachi.
She advised “low glycaemic index, high-fiber foods” that release energy slowly before and after fasting to keep blood glucose normal.
They must avoid sugary desserts such as jalebi, cakes or kheer.
Diabetes patients need to drink plain water or non-sweetened beverages after iftar and before sehri. Caffeinated and any sweetened drinks should be avoided.
Those diabetes patients who also have kidney and heart disease should not fast due to the high risk, she said.
Before Ramazan, it is necessary that those with diabetes or pre-diabetes go to their doctors for a full clinical assessment.
She added that self-glucose monitoring and medicines to avoid hypoglycaemia are important.
Hypoglycaemia is low blood sugar – diabetes patients have a very risk of developing it.
When blood sugar levels fall below normal, it triggers the release of epinephrine (adrenaline), the “fight-or-flight” hormone. This can cause fast heartbeat, sweating, tingling and anxiety.
If this is not treated, the supply of glucose (sugar) to the brain is affected which can result in blurred vision, difficulty concentrating, confused thinking, slurred speech, numbness, drowsiness, seizures, coma and rarely death.
Blood sugar levels should be monitored regularly during the fast.
Patients must check their glucose levels whenever they experience symptoms of hypoglycaemia or hyperglycaemia (high blood sugar).
They must understand that at the first sign of any of the symptoms, they should immediately break the fast, Dr Bashir said.
Those people on insulin therapy need to monitor their glucose more frequently. It is important for them to measure blood glucose after iftar to detect postprandial (after meals) hyperglycemia, she advised.
Diabetes patients should reduce physical activity during the day. Any sort of exercise is okay one hour after iftar.
Once Ramazan ends, they need to visit their doctors for a review and adjustment of diet, exercise, and medication.