Diabetics asked to seek medical advice before fasting
May 13 2017 09:04 PM
Prof Abdul-Badi Abou-Samra says diabetics should speak to their healthcare team before Ramadan begins.


Hamad Medical Corporation (HMC), in advance of the holy month of Ramadan, is cautioning individuals with diabetes to seek medical advice before fasting. 
According to Prof Abdul-Badi Abou-Samra, chairman of Internal Medicine at HMC, fasting among patients with Type 1 diabetes, and among those with Type 2 diabetes who have inadequately managed blood glucose levels, can have many risks, including dangerously low or high blood glucose levels, diabetic ketoacidosis and blood clots. 
“If you are planning to fast and you have diabetes, it is important to speak to your diabetes healthcare team before Ramadan begins. For some people with diabetes, fasting can be dangerous. Your diabetes care team will 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, including providing advice on necessary modifications to your diet, exercise and medication routines as well as guidance on when it might be necessary to break your fast,” said Prof Abou-Samra. 
The fall of blood sugar (below 70mg/dl) may lead to severe hypoglycaemia and loss of consciousness. High blood glucose (above 200 mg/dl) may lead to severe hyperglycemia, dehydration and diabetic ketoacidosis, particularly in Type 1 diabetics.
“When the body’s cells don’t get enough glucose, the body burns fat for energy and this causes waste products called ketones. Ketones can make the blood acidic and this can be fatal. Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours.
"For some individuals, diabetic ketoacidosis can be their first symptom of diabetes. Common symptoms of diabetic ketoacidosis include excessive thirst, frequent urination, nausea and vomiting, abdominal pain, weakness or fatigue and fruity-scented breath,” added Prof Abou-Samra. 
Individuals with Type 1 diabetes who choose to fast are at a higher risk of developing ketoacidosis, especially if they have been experiencing hyperglycemia in the weeks leading up to Ramadan.
While fasting is not recommended for all diabetics, many individuals with diabetes are able to safely fast. However, Prof Abou-Samra stresses that it is important to get medical advice prior to making any changes to diet or medication routines.
“If you are diabetic and fasting during Ramadan, we recommend checking your blood sugar levels frequently. It should be checked at least four times daily during fasting, for example at 11am, 1pm, 3pm and 5pm. If any of these tests show signs of hypoglycaemia, it is necessary to break the fast. Your physician or diabetes educator can provide more details about controlling blood sugar levels and can help you understand when it would be necessary to break your fast,” said Prof Abou-Samra.

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