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Muslims around the world fast in this holy month of Ramadan -- from pre-dawn hours to dusk. Health experts have a word of caution for those who may be diabetic. Due to prolonged fasting, diabetics undergo metabolic changes as they don't eat anything for long, say medical experts. 'Prolonged fasting results in metabolic changes which necessitate adjustment in diabetes management plan, in terms of dietary intake and medication schedule. During Ramadan, most people take two large meals with a gap of 12 to 15 hours,' said Atul Luthra, senior consultant physician, Fortis C-Doc.
He said carbohydrate and fat intake should be kept under control to prevent blood sugar from rising rapidly during the day, or between 'sehari', the early morning meal prior to the beginning of the fast, and the 'iftaar', the ritual breaking of the fast in the evening hours. 'Diabetics should not indulge in high-calorie, high-refined food. Rather, they should take food with high fibre content. All patients must be aware of the warning symptoms of low blood sugar and they should not continue with the fast if the symptoms appear,' he added. The problems diabetics face while fasting can either cause hypoglycemia (sudden fall in blood sugar levels), which can cause seizures and unconsciousness, or hyperglycemia (increase in blood sugar). (Read: 10 tips to prevent diabetes)
Doctors add that their condition can worsen with a 'potentially life-threatening complication' called diabetic ketoacidosis which causes vomiting, dehydration, deep gasping breathing, confusion and even coma. 'They can also develop thrombosis, which leads to formation of a blood clot inside blood vessels,' Luthra warned. Ansar Ahmad Siddique, a 45-year-old diabetic who religiously fasts during Ramadan, balances his meals to keep his blood sugar level normal. 'I observe Ramadan all 30 days. I do have jamun and papaya to keep my sugar level normal. However, if I face any problems, I take medicines,' the businessman told IANS. (Read: 10 diet dos and don'ts for diabetics)
According to Luthra, Type 1 diabetics, or those who have a history of recurrent hypoglycemia, are at a higher risk if they fast. 'Hypoglycemia and hyperglycemia may also occur in patients with Type 2 diabetes but generally less frequently and with less severe consequences as compared to Type 1 diabetics,' he added. S.C. Juneja, endocrinologist at the Diabetes and Health Care Centre in west Delhi, said only those who take insulin, which helps regulate sugar in the bloodstream, once a day can fast. 'But those who take it twice or more should refrain from fasting as it becomes necessary to eat after taking insulin,' Juneja told IANS. (Read: 10 ways to control diabetes naturally)
Agreed Sujeet Jha, diabetologist at Max Hospital (Saket) in south Delhi. He said that even if diabetics wish to fast, they must not skip their medicines. 'Patients on insulin should completely avoid fasting. Having nothing for almost 14-15 hours a day at a stretch can lead to low sugar levels. They should also be well hyderated,' Jha told IANS. Experts say that patients should regularly consult doctors and follow the suggested medication. Juneja said there should be frequent monitoring for diabetics to ensure safe fasting, and they should eat more fruits and vegetables along with high fluid during the non-fasting period. 'Carbohydrate and fat intake should be kept under control to check blood sugar. Diabetics should not take high-calorie and high-refined foods. They should instead take food high on fibre content,' Juneja told IANS.
Sweets must be shunned while breaking fast. 'Patients should include fruits, pulses, vegetables and curd in their diet while breaking fast. There should be least sugar in drinks, and fried food should be avoided. Items containing starch like basmati rice and wheat chapati can be taken,' Luthra advised. Jha added: 'Patients should take a walk or exercise in the evenings.' (Read: Home remedies for diabetes)
Here are some healthy resolution for diabetics
The new year is just around the corner, and this is when a number of people start thinking about their resolutions. If you are a diabetic, this is the time you should focus of getting yourself on track health wise. Here are ten resolutions that every diabetic should take in order to stay healthy in 2014.
Resolution #1:Check blood sugar levels regularly
For a diabetic his/her blood sugar level is an extremely important aspect of staying healthy. It indicates how well you are managing your diabetes and, if you have either high amounts of blood sugar (hyperglycaemia) or low blood sugar levels (hypoglycaemia) in your blood both of which are extremely dangerous.
Hypoglycemia is a condition in which the blood glucose levels drop below the lower normal limit (80 mg), and it affects the working of the entire body. The common symptoms of the condition are lethargy, decrease in mental function, irritability, shakiness, weakness in the arm and/or leg muscles, sweating and loss of consciousness. In severe cases, one may suffer from brain damage as well.
In the case of hyperglycaemia, one's blood sugar levels are higher than the normal limit (120 mg). While suppressed appetite is a short-term symptom, long-term symptoms include eye, kidney and nerve damage plus increased risk of heart disease.
What you can do about it: The best way to check your blood sugar levels at regular intervals is to have a glucometer at hand. According to Dr Rajiv Kovil, 'A type 2 diabetic should measure his/her glucose levels once before a meal and once two hours after a meal. This should be done on different days at different times, also known as scattered checks. In the case of people suffering from type 1 diabetes, they should get a 7 point check, before and after meals, along with a 3 am reading.' This new year try to invest in a blood glucometer, it will not only cut down all the trouble of going to a hospital to get your blood tested, but will also make the process much more convenient.
Resolution #2: Get your HbA1 checked twice a year
HbA1c (Haemoglobin A1c) is a simple blood test that tells you and your doctor how well your diabetes is managed over time. It is aimed at measuring your average blood sugar levels, and to see if it has stayed within the required range. The test works by measuring the amount of glucose that gets attached to your red blood cells that are said to be 'glycated' when the glucose molecule gets attached to it. This means that the higher the amount of glucose that gets attached to the cells, the lesser the amount of oxygen the cells can transport to your body and tissues. The average percentage of glycoslated cells directly translates to the HbA1c reading. According to Dr Rajiv Kovil, renowned diabetologist, 'A diabetic should get his/her HbA1c levels tested every six months, and the level should be below 7% to avoid any further complications.' A normal person's HbA1c level is usually below 5%, but in a diabetic this level is increased because of the amount of glucose in their blood. An average above 7% is an alarm that you are more susceptible to diabetes related complications. Uncontrolled diabetes can raise the risk of you developing eye diseases like diabetic retinopathy by 76%, Kidney disease by 50% and nerve damage by 60%*. Read more about 10 healthy resolutions for diabetics
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