For a diabetic, fasting during Ramadan demands a considered approach. During the Holy Month, you usually fast for 13-14 hours and often tend to have erratic sleep patterns. This can adversely impact metabolism and cause fluctuations in blood sugar levels. During the period of fasting, the body starts using the stored energy through fats and carbohydrates, so, a diabetic, whose insulin levels are not well-monitored, can end up suffering from hypoglycemia, which can be fatal.
Guidelines for safe fasting for a diabetic
Meet your endocrinologist for an assessment of medical parameters and review. One requires the insulin dosage to be adjusted according to the meal timings. For example, during pre-dawn meal, one might be required to reduce the dosage of insulin, if it is used at regular intervals. There might also be a change in the dosage of medications, but don’t skip your insulin.
Learn to self-monitor blood sugar levels. Check it frequently to prevent hypoglycemia or hyperglycemia, for example, before iftar and suhour, in between the fasting period for at least two or three times a day. Learn more about the signs of hypoglycemia. When blood sugar levels go less than 70mg/dl, it is hypoglycemia. Remember and note the basic symptoms of hypoglycemia, like severe sweating, shakiness, inability to think clearly and confusion. Severe hypoglycemia can lead to seizures.
Distribute your total calorie and carbohydrate intake during the eating period. Take advice from a professional dietician or nutritionist. For example, have 30 to 35 per cent of the total calories of the day during suhour, 40 per cent during iftar and remaining can be divided into two mid-healthy snacks as 15 per cent in one and 10 per cent in another.
Have a balanced diet — carbohydrates (40-50 per cent), protein (20-30 per cent), fat (less than 35 per cent). Make sure to have 25-30 grams fibre per day. Try to include all five food groups and keep your plate colourful with antioxidant-rich foods. Avoid refined and fried foods.
Increase your water consumption. Get into a habit of having at least 1.5 litres in eight hours. Maintain hydration as much as possible and avoid sweetened beverages, especially during iftar.
Never skip suhour. In fact, try to eat late during suhour. Have carbs that can be slowly absorbed by the body (essentially, foods that have low glycemic index and ones that are high in fibre). This will prevent hypoglycemia and will keep giving you energy throughout. Include foods like barley, oats, quinoa, cereal, couscous, lentils in the pre-dawn meal.
Make sure to add seeds like flax seeds, chia seeds or nuts like almonds in your dessert cup as this will help to not only add fibre but also, but also Omega-3 fatty acids in one cup. Try to use natural sugars like date syrup, fruits, molasses for sweetening.
Make sure to do light-to-moderate intensity exercise between iftar and suhour, as this will help keep your blood glucose levels under check.
Remember, pre-Ramadan assessment and a structured education is key for safe fasting for people living with diabetes. Structured information can include information about risks, medication adjustments, self-monitoring, identification of symptoms of complications and to know when to break the fast to avoid them. Be mindful of the food you choose to eat in the non-fasting periods. Always consult your physician or healthcare provider before you begin the fasting journey.