It is important for diabetics to keep a sharp watch on their health status while fasting for Navratri or Ramzan
Diabetes patients need to manage risks while fasting during the Navratris and upcoming Ramzan. Diabetes can aggravate problems like hypoglycaemia, hyperglycaemia, dehydration and acute metabolic complications such as diabetic ketoacidosis.
According to the IDF Diabetes Atlas: “Diabetes kills 1 person every 8 seconds, around the world. Worldwide, 451 million people are diabetic out of which 72.9 million are in India”.
Fasting is a major trigger which worsens the condition of a diabetic. According to Dr. Satish Koul, Senior Consultant & Director, Narayana Hospital, Gurgaon: “With diabetic patients deciding to fast, the importance of practical diabetes and spiritual fasting guidance becomes evident. Potential health hazards include hypoglycaemia, hyperglycaemia, dehydration and acute metabolic complications such as diabetic ketoacidosis. During fasting our body’s system goes through a lot and that depends on the length of the continuous fasting. When we fast the body initially uses stored sources of glucose and then later it breaks down body fat to use the next source of energy. It is important to keep a tap on your blood glucose levels as the chances are that during fasting your blood glucose levels may drop too low. It is advisable to keep your doctor informed if you decide to fast.”
Dietary advice during fasting for patients with diabetes
- Ensure meals are well balanced
- 45–50% carbohydrate
- 20–30% protein
- <35% fat (preferably mono- and polyunsaturated)
- Include low glycaemic index, high fiber foods that release energy slowly before and after fastingE.g. granary bread, beans, rice
- Include plenty of fruit, vegetables, and salads
- Minimise foods that are high in saturated fatsE.g. ghee, samosas, pakoras
- Avoid sugary desserts
- Use small amounts of oil when cookingE.g. olive, rapeseed
- Keep hydrated between sunset and sunrise by drinking water or other non-sweetened beverages
- Avoid caffeinated and sweetened drinks
According to IDF Diabetes Atlas 2017, 693 million people are going to be affected by diabetes as it is expected to increase by 2045. Kerala has the largest number of diabetes patients followed by Tamil Nadu and Punjab.
Do’s and don’ts while observing a fast for diabetic patient
- Consult your doctor prior to, during and post fasting
- Include high fiber food in your diet
- Drink plenty of water and sugar-free beverages during non-fasting hours
- Monitor your blood sugar levels multiple times daily, especially if you are taking insulin
- Include plenty of fruits, vegetables in your meals
- Do not ignore any of the warning signs of low or high blood sugar levels and consult your doctor immediately
- It is advisable not to continue fasting if blood sugar level goes below 70 mg/dL or if it goes above 300 mg/dL
- Limit the intake of fried food, sweets, and caffeinated drinks as much as possible
- Avoid excessive exercise, especially during fasting hours
- In any case, do not stop taking medicines without consulting your doctor
All diabetic patients who fast during Navratras and Ramzan should undergo an evaluation for 1 or 2 months before the start of spiritual fasting to determine their level of diabetes control and the presence of acute and chronic complications of diabetes and other comorbid conditions.
Specific attention should be devoted to patients’ overall well-being and to the control of their glycemia, blood pressure, and lipids.
According to Dr. Rajesh Kesari, Endocrinologist, Total Care Control Diabetes Care Centre, Delhi: “In Type 2 diabetes you see that people are generally obese and have large abdomens. As the patient gain weight, it gets worst. There is a need to take more insulin, which means to gain more weight. Resulting in a vicious cycle. a moderate and properly consulted intermediate fast can be good got diabetic patient for losing weight, and help control the blood glucose, blood pressure, and cholesterol levels. However, fasting should not be done without consulting a doctor. Patient should plan a visit to the doctor 6 – 8 weeks ahead to get an overall assessment to decide his or her risks during fasting. It is important for Choosing healthy options while breaking fast, regular monitoring of sugars at home with a glucometer, learning to identify symptoms of high or low sugars are crucial during the fast.”
