Diabetes is one of the most prevalent diseases in the world, and doctors are always keen to advise their patients during Ramadan or if the patient is accustomed to fasting for some days, to establish a nutritional and medicinal program in order to monitor the condition and not be affected by fasting, which may cause an increase or decrease in the level of sugar. Diabetes is of two types; The first patient receives insulin because the pancreas needs it because it does not produce it, while the second type comes as a result of its association with advanced age, obesity, and heredity.
Dr. Muhammad Juma, a family medicine consultant at the Prince Abdul-Majid Al-Moatazhi Health Center in Jeddah, believes that diabetes is one of the most common chronic diseases in the Kingdom, and every patient should monitor his health status and know the extent to which he can fast or not based on the type of infection, whether it is the first or the second type, and follow up on sugar readings. And the presence of chronic diseases such as pressure, heart and others, based on laboratory and clinical analyzes and examinations, and we must know that each diabetic patient has his own situation.
In this case, break the fast immediately
Dr. Jumaa explains that cases of diabetics are divided into several categories, some of which may be more at risk as a result of fasting while they are sick: type 1 and those who suffer from poor blood sugar control and those who suffer from severely low blood sugar, or have previously had diabetic ketoacidosis, as well as patients Very low blood sugar, or unawareness of low blood sugar and those with severe kidney disease or vascular complications. Dr. Jumaa advises patients with type 1 diabetes, if their health condition may be affected by fasting, to resort to breaking the fast, as this type is dangerous as a result of the changes that may occur in the sugar level, because they are exposed to ketoacidosis in the blood. The consultant, Jumaa, adds that there is a general rule for a diabetic patient, so that if the sugar decreases at the beginning of the fasting day to less than 70 mg or if it rises above 300 mg, and the patient feels severe hunger, thirst, and exhaustion, he must break his fast and break the fast immediately, warning diabetics not to follow their desires to eat. Eating foods, especially since some tables contain many foods of different nutritional value, and every diabetic patient must develop a comprehensive plan for the quantity and size of the daily breakfast portion so that it does not cause carbohydrates and high fats, and to replace unhealthy foods with salads, vegetables and fruits in limited quantities, and it is better to divide breakfast into two meals Or three over an hour or two to avoid a sudden increase in the level of sugar.
Family medicine consultant, Dr. Jumaa, explained that dates contain useful vitamins, minerals and sugars, which are certainly better in health than monosaccharides, but he warned at the same time against increasing the intake of dates from one to three tablets per day in total.
They can fast
Senior internal medicine specialist, Dr. Abdullah Baatia, divided the fasting diabetics into three categories, the first: she suffers from a very high risk as a result of a sharp and repeated drop in sugar for the last 3 months and her exposure to ketoacidosis, and for this reason doctors see that this type of diabetes is not controlled, so treatment is prescribed Insulin is for him, and with those also patients who suffer from kidney failure, who are undergoing dialysis, as well as patients who suffer from arterial insufficiency and weakness in the heart muscle, for all these patients, doctors usually do not advise them to fast, whether it is fasting the month of Ramadan or a voluntary fast or a vow. . The second category is diabetes patients who are described as high risk, and those who suffer from poor control of type 2 diabetes and take multiple insulin doses, and pregnant women who treat diabetes with a regulator, and with them patients who suffer from kidney failure of the third degree, as well as professions that require physical effort. High and all of these are usually advised by doctors not to fast. As for patients with moderate or low risk of type 2 diabetes who control their sugar, they can fast.
complex sugars rather than simple ones
The specialist, Dr. Baatia, believes that the possible complications for a diabetic patient during fasting are the emergence of symptoms and complications of a sharp drop in sugar or a rise, ketoacidosis, dehydration, insufficiency in kidney function, and an increased risk of clots. Therefore, he advises those who wish to fast, especially during the month of Ramadan, to follow up with their doctor. Specialist for a period of not less than 6-8 weeks before the start of the month of Ramadan, with the aim of regulating sugar, organizing treatments, and adjusting the diet.
Dr. Baatia advises diabetics to drink more water during the non-fasting period, to reduce stimuli and caffeine, to initiate breakfast and delay the pre-dawn meal, while eating a balanced healthy diet rich in protein and fiber, relying on complex sugars instead of simple sugars, and monitoring blood glucose frequently during the day, and he should stop drinking Fasting when the blood glucose level is less than 70 mg/dL or higher than 300 mg/dL.
Measurement at noon and sunset
Endocrinologist and diabetes specialist, Dr. Mamdouh Salem, said that he advises not to fast patients with type 1 diabetes, but if he wishes to fast, he must follow some precautionary and preventive steps that must be taken to avoid high or low sugar, including delaying the suhoor meal as much as possible so that it does not take too long. his fasting period.
He added that the diabetic fasting person, when eating breakfast, must break his fast with salad, and after 10 minutes he completes his food, and it is desirable that it be starches, vegetables and protein, while replacing sweets with fruits and vegetables, warning patients with type 1 diabetes not to eat kunafa and qataif without referring to the specialist doctor to correct his intake. Insulin doses to avoid a rise in blood sugar, with the importance of his keenness to measure the blood sugar level in the morning, afternoon and before breakfast to follow up measurements of high or low blood sugar, with the importance of drinking enough water to maintain the moisture of body cells and blood fluidity.
"Health" advises and directs
The Ministry of Health was keen to give some advice to diabetic patients when they wish to fast, the importance of consulting a doctor before starting fasting to determine the patient’s ability to fast and adjust his treatment doses, stressing at the same time the importance of taking diabetes medications regularly according to medical instructions, and the need to continue physical activity between light and medium. Especially in the evening time. She also urged diabetic patients to test the level of glucose in the blood daily, two hours before and after breakfast, before suhoor, and in the middle of the day, and to drink an adequate amount of water after breakfast, and to reduce the intake of foods rich in sugars and fats, and to avoid overeating; By dividing breakfast into several moderate meals.
Mohammed Al-Hattar (Jeddah) @alhattar