Diabetes and Fasting in Ramzan ( Roza )
Ramadan is 8th month of Islamic calendar. Islam has made fasting compulsory for every adult Muslim who is physically healthy. Ramadan month Contains 29 or 30 days his duration. A fasting duration starts from seher (very early in the morning) and ends on Iftar (the sunset). Its duration depends on geographical location and season, in some areas of the world its duration may be more than 20 hours. In Ramadan, while fasting the Muslims are abstain from eating, drinking, sex relation, use of oral medications and smoking from seher (very early morning) to Iftar (sunset). Now we describe some details about Diabetes and Fasting.
O believers Fasting has been made obligatory on you, as it was made obligatory on those before you – perhaps you become pious.
As above mentioned that fasting is compulsory on healthy persons not the person, who are sick and on journey, its mean that the Islam does not create excessive hardship by fasting on Muslim individual. In the quran Kareem Allah has said that “But whoever of you is ill or on a journey, then let them fast an equal number of days after Ramaḍân”.
(Holy Koran, Al-Bakarah, 183–185)
In case of, where the fasting might create critical condition or harmful consequences, during Ramadan or fasting, for the Muslim individual. Where the diabetic persons are concern, depends on their health condition. If they are in good health condition, then they can keep fast, otherwise they must not keep fast and they should pay redemption as in Quran narrated. For the diabetic persons, in critically condition, their metabolic disorder may can put them in any complication.
Persons with diabetes, especially persons who depend on insulin, fall in Quranic patient definition, because in fast their sugar level may be able to become low or they can suffer from many complications. So diabetic person must consult diabetes specialist in this matter, whether they should fast or not. Usually Medical specialists suggest the diabetic persons to take 4 to 5 light meals in a day, whereas in fasting it is not possible.
It is not permissible to take food, drink or medicine during the fast of Ramadan, while a diabetic can be harmed by prolonged hunger. In this case, diabetic person can suffer from hypoglycemia, so it is discussion in this matter, whether diabetic persons should fast of Ramadan or not. Diabetic persons should consult islamic scholar to get opinion after physician.
Fasting during Ramadan is undertaken to promote chastity and humility and as an act of submission to Allah.
Is fasting with diabetes dangerous to health?
A lot of persons with diabetes usually wish to fasting in Ramadan, and they remain safe from any complication, but sometimes, in fasting, diabetic persons suffer from hypoglycemia and they become unconscious. The person who are taking medication to control the blood glucose level, the should consult the diabetes specialist to get advise, whether they should fast or not according their present condition.
Eating at sehri (very early morning) and taking blood glucose lowering medication can cause severe hunger and physical weakness during the day. The patient may suffer from hypoglycemia and become unconsciou. At the iftar time, the person have to eat the food in large scale, while eating too much is cause of increasing high blood glucose level after iftar and remain whole night. This condition also unpleasant for diabetic persons. So good decision must take in Ramadan whether fasting or not. Islamic scholar and diabetes specialist can right advice in this matter.
Should people with diabetes fast during Ramadan?
People are recommended not to fast if the act of fasting could negatively affect their health.
In the Quran kareem Allah Taala had said;
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.
In this difficult situation it is best to consult with doctor and religious scholar about how best to respect the fasting period. Be sure to consult with you doctor if you take part in the fast.
How to keep control blood sugar level in the fast of Ramadan?
Controlling the blood sugar levels while fasting
For the diabetic persons, hyperglycemia or hypoglycemia is not a good sign, but specially in Ramadan fasting this condition is very dangerous situation. So, it is advised to the diabetic person that they must keep eye on their blood sugar level during fasting To avoid any sudden trauma. In case of a diabetic person is taking blood glucose lowering medication. If diabetic person taking blood glucose lowering medication, they keep any sweetener in the pocket, in case of sudden hypoglycemia during fasting.
Principals and some things to remember during fasting
Here are some points that diabetic persons should follow during fasting
Diabetic person must keep monitor the blood sugar level during fasting. It is very important for the diabetic person to monitor his blood sugar level, it is key to be safe during fasting.
Avoid to over eat
Overeating can increase blood sugar level, so do not overeat at all. Basic theme behind fasting is to control the personal desires, pray to God and keeping the body healthy through controlling the foods.
Things to avoid in fasting
Diabetic person must avoid things that cause high blood sugar like soft drinks and sweets, also must avoid from sugar base foods in sehri and iftari.
To avoid from hyperglycemia, at iftar time break the fast with natural fruits having low glacemic index, and avoid to eat high glacemic index like date and mango or mango juice. Use sugar free foods and drink the sufficient liquid to rehydrate your body and avoid dehydration.
Reduce the extra sweets consumption during fasting.
Include low glycemic fruits like apple, Pears, Peaches
vegetables like Green peas, green beans. tomatoes. cucumbers
and having low quantity of calories like Greek Yogurt, Eggs, Fish etc.
Do some exercise or walk after eating so that the food is digested and go to bed about 2 hours after eating.
In sehri meals use low glycemic things and right nutrient intake. The diabetes specialists suggest whole grain bread, beans, lentils and whole grain low sugar cereals.
Avoid deep fried foods such as paratha, puri, samosa, chwera and pakoras. Starch containing items such as rice and wheat chapatti can be consumed.
What are the main things to remember if you’re diabetic and are fasting for Ramadan?
1- Consult your doctor before you decide to fast to understand the state your body will get into. • If you still want to fast, understand the risks completely by reading or talking to people.
2- Plan your meals and the type of meals for each day, and incorporate foods that will keep you full for longer.
3- Alter timings for your medications to avoid hypoglycaemia.
4- Regularly check your blood sugar levels to avoid any unseen complications.
5- Keep yourself hydrated and avoid caffeinated or sugary drinks.
6- When breaking a fat, avoid large quantities of food. Not all bodies are same and not all diabetics get affected the same way. Some of them can fast without any risks to themselves.
But just because you know someone with diabetes, who has been successful at fasting, it does not mean you can assume the same for yourself.
There is also not enough literature available to understand what this type of fasting can do to diabetic patients. So, if you see fatal signs during your fasting period, it is best to stop.
Some complications in Ramazan with Diabetic Patients
In Islamic pricipals there are some special conditio where some type of exemptions apply like fasting exempt in acute condition. persons with svere diabetes are exempt from fasting according to the Quran but for personal satisfaction, some people go ahead anyway without realizing they are putting themselves into the various risks.
Individuals with diabetes are exempt from fasting, according to the Quran, but for personal satisfaction, some people go ahead anyway, without realizing the various risks they are putting themselves into.
Some major risks of Ramadan fasting include
- Hypoglycaemia (Low blood sugar )
low blood sugar levels: This is most probable in patients consuming medicines for diabetes. It’s best to refrain from excessive physical activity during the fasting period.
- Hyperglycaemia ( high blood sugar level )
This is probable if you overeat a meal due to the hunger when the fast is broken. Evening meals in many houses are considered a massive celebration, which sometimes involves overindulgence in food. Thus, consuming moderate quantities of food is advised.
This becomes a big problem for all who fast and are out all day. The summer seems to worsen this situation. More fluids with less sugar and caffeine are encouraged.
These risks are higher for patients suffering from diabetes. This is because of the fluctuating blood sugar levels and the tablets or insulin they consume. It is definitely not advisable to stop medications for diabetes for the fear of having hypoglycaemia.
The only tweak that should be made is the timings at which the medicines are consumed. Because not taking the medications also puts you at a risk of hyperglycaemia after large pre-dawn or post-sunset meals.
Patients with diabetes, especially those with type 1 diabetes, who fast during Ramadan are at increased risk for development of diabetic ketoacidosis, particularly if they are grossly hyperglycemic before Ramadan. In addition, the risk for diabetic ketoacidosis may be further increased due to excessive reduction of insulin dosages based on the assumption that food intake is reduced during the month.