Posted on May 17, 2017

For most individuals, fasting during the holy month of Ramadan has numerous health benefits, including protecting the heart from cardiovascular disease by lowering bad ‘LDL’ cholesterol levels, increasing good ‘HDL’ cholesterol levels and promoting fat breakdown and weight loss. However, for diabetics, fasting can be complex and can have serious health risks.

While individuals with Type 1 diabetes are generally advised not to fast, most Type 2 diabetics are able to fast without complications. Those who should avoid fasting include individuals with poorly controlled diabetes, elderly patients with Type 1 or Type 2 diabetes who take insulin, children under the age of puberty and those who are acutely ill or frail. All pregnant women who take insulin and breastfeeding mothers, whether they have Type 1 or Type 2 diabetes, are advised not to fast.

“Having diabetes may place an individual at risk of various complications if their eating pattern and amount of food and fluid intake is markedly altered. Successful blood sugar management is the key to living well with diabetes and this relies on healthy meals eaten at regularly spaced intervals. Whether an individual has Type 1 or Type 2 diabetes, fasting should be approached with care,” says Dr. Mahmoud Ali Zirie (pictured), Senior Consultant and Head of HMC's Endocrinology and Diabetes Division. “Careful monitoring of physical activity, nutrition, glucose levels and dosage and timing of medications is essential.”

According to Dr. Zirie, for individuals living with diabetes, it is particularly important that they break the fast gently. He said long periods without food or water put diabetics at risk of low blood sugar levels and dehydration, adding that Qatar’s hot climate increases the potential for fluid loss. Dehydration can cause high blood sugar levels if individuals eat excessively during the Suhoor and Iftar meals, which highlights the importance of distributing food over two to three smaller meals during the non-fasting intervals.

“Patients with diabetes must ensure they eat the Suhoor meal and they should eat sensibly – being mindful of the types of food eaten as well as the quantity. Overeating at Suhoor or Iftar could cause a sudden increase in blood glucose levels. It is also important to drink adequate fluids during non-fasting hours, aiming for eight glasses a day and ideally choosing water or another sugar-free beverage,” said Dr. Zirie.

Dr. Zirie stresses that diabetics who fast should monitor their blood glucose regularly and should limit their intake of fried, fatty or sugary foods. He says it is essential for diabetic patients to control their intake of high carbohydrate foods, as foods high in carbohydrates affect sugar levels. Carbohydrates with a low glycemic index such as brown rice, full grain bread, and vegetables are better options than white rice, packaged sugary baked goods and full-fat dairy.

The Ministry of Public Health, HMC and the Primary Health Care Corporation (PHCC) have partnered again this year to provide the public with information about common health issues through the Ramadan Health website. Introduced last year, the website is Qatar’s first online resource devoted to health and wellness during Ramadan and is available at www.hamad.qa/ramadanhealth.

For tips and information about living well with diabetes during Ramadan, and throughout the rest of the year, visit diabetes.hamad.qa. The website contains information on fasting with diabetes and also has helpful resources, including our diabetes cookbook with diabetic-friendly versions of recipes for popular dishes such as biryani and thereed.

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