Diabetes And Ramdhan Fasting

The following patients having diabetes should not fast ( orelse should seek an advice before fasting)

1) Patients whose blood sugar has anytime remained above300mg or below 70 mg in the preceding three months.

   

2) Patients whose HBAiC his above 8.5%

3) Patients who require frequent insulin injections apartfrom morning and evening doses.

Diabetic patients who can fast:

1). Patients whose diabetes is controlled on diet andexercise alone

2) Patients whose diabetes is controlled on Metformintablets

3 ) Patients who are controlled with other oral drugs. Theyshould reduce the dose of medicine by 50% at sahri.

4) Patients who are controlled on single dose of nightinsulin should reduce the dose of insulin by 25%. For example, if a patient iscontrolled on a single dose of 20 units of insulin at night, he should takeonly 16 units of insulin. Tea should be avoided during Ramzan fasting by thediabetics as it leads to dehydration.

5) If a diabetic patients take morning dose of insulin also( in addition to his evening dose) he should reduce the morning dose by 50%.For example, if a patient takes 20 units of insulin in the morning, he shouldtake only 10 Units.

6) As already told if a patient takes insulin in the eveningalso, he should reduce evening dose by 25 % only( for 20 units he should takeonly 16 units)

7) If patient needs frequent regular insulin dosing duringday (apart from morning and evening doses) such a patient should not fast.

8 ) A diabetic who is fasting should monitor blood glucoselevels 2 hours after Sahri, at noon time, mid day to see what are the sugarlevels. This is especially for those who are on insulin and other oral drugsapart from Metformin. If sugar level goes above 300 mg or is slipping down 70mg, the patient should break his fast

 9) Diabetic patientwho is fasting should avoid strenuous exercise during fasting hours as it maylead to hypoglycemia( low sugar levels) which may prove dangerous

10). If a fasting diabetic patient feels sensation ofdizziness, gets palpitations and sweating with a feeling of fainting, it couldmean low blood sugar levels, he should immediately break the fast.

Remember, if the fasting blood sugar goes below 65 mg thepatient should immediately break the fast even if Iftar time is just tenminutes away, otherwise it can prove disastrous.

God Bless all patients.

Dr. A. Wahid is Ex HoD Medicine, SKIMS, Srinagar

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