Ramadan Poses Challenges for People With Diabetes

Ramadan, the lunar-based celebration in Muslim culture that started yesterday in the U.S., may pose unique challenges for people with diabetes, experts warn.

The 29- to 30-day period involves fasting during the day and unlimited food consumption between sunset and dawn.

For many people, fasting is safe - and even an effective way to cleanse, lose weight and deepen one's spiritual practice - but for diabetics, Ramadan may need to be approached with caution.

According to Dr. Kim A. Carmichael, associate professor of medicine at the Washington University School of Medicine, meals should be balanced and healthy during Ramadan. Maintaining one's body mass index should also be a goal, he said.

"Important factors to improve safety include a sensible diet, minimizing the use of simple carbohydrates and fats during the evening and early morning meals, maintaining good sleep hygiene, avoiding excessive exercise, maintaining adequate fluid intake and checking blood glucose levels frequently,” Dr. Carmichael told Endocrinology Advisor.

Medication and hydration

Another important factor to consider during Ramadan is medication adherence, Carmichael said.

“Metformin therapy is considered to be safe during Ramadan, as long as persons maintain good fluid intake," he stated.

Individuals should also take into account how their insulin therapy might need to be adjusted due to changes in meal times or sleeping.

According to Farhad Zangenah, assistant clinical professor of medicine at George Washington University School of Medicine in Sterling, Virginia, diabetic patients must be particularly aware of their fluid intake.

Hospitalizations have increased this month for type 1 and type 2 diabetes, Zangenah said, which can be due to any number of minor or major complications.

While religious practices and preferences remain an individual decision, doctors generally advise diabetic patients to avoid fasting and maintain a normal schedule during Ramadan.

“The Holy Koran specifically exempts the sick from the duty of fasting, especially if fasting leads to comorbidities for the individual," Zangenah said. "Patients with diabetes mellitus 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."

Source: Endocrinology Advisor
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