Doctors urge Muslims with chronic medical conditions not to fast

Diabetics in particular are being advised to be cautious during daylight hours, as going without food for long periods can cause fluctuating blood sugar levels.

Diabetic Aisha Hamilton wears a blood sugar monitoring device and says people must be fit to fast. Vidhyaa for The National
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ABU DHABI// With Ramadan approaching, Muslims with chronic medical conditions are urged to visit doctors to ensure their medication is up to date and to not risk their health by fasting.

Diabetics in particular are being advised to be cautious during daylight, as going without food for long periods can cause blood sugar levels to fluctuate.

Dangerously low blood sugar, or hypoglycaemia, can occur in anyone but is more common in diabetics taking certain medication, and during periods of irregular eating or fasting.

Weakness, hunger, high heart rate and confusion are all symptoms, with loss of consciousness and coma possible in extreme cases.

Aisha Hamilton, a nursery manager from Scotland, has been a Muslim for about 16 years. She was diagnosed with diabetes eight years ago, but suffered a series of strokes during Ramadan while on holiday.

“I wasn’t fit to fast and that should be the message,” she said. “I was playing golf and started to feel sick. An ambulance took me to hospital and a brain scan showed I had a stroke.

“I thought I was healthy, and you never think I was at risk from a stroke or that it could be related to my blood pressure or diabetes. It is very dangerous.”

Fasting is recognised as having health benefits such as lowering blood pressure and cholesterol, as well as weight loss, but is not always safe when some medical conditions are involved.

Since recovering, Ms Hamilton has a well-worked routine during Ramadan so she can still observe periods of fasting and she continually monitors her blood sugar levels.

“I have tablets to take in the morning and at night,” she said.

“Before suhoor I’ll take my morning medications and when I have dates and water in the evening I’ll take my second lot. As long as you keep it consistent, it’s OK. You have to be sensible, listen to your body and your doctor.

“Some people make themselves sick through fasting – that in itself goes against the Quran.”

Ms Hamilton wears a needle and sensor on her arm, about an inch in diameter, giving information on her average blood sugar levels during the day and when she is in danger of falling ill and should eat.

Sensors cost about Dh250 and must be replaced every two weeks. The machine to collecting her blood data costs about Dh450.

“It’s so much better than pricking your finger five times a day to get a reading on your blood,” she said.

“The information can be sent via my phone to my doctor, so he can monitor my health, too.”

Doctors said it is important to not break the fast with large meals, as there is a potential risk of post-meal hyperglycaemia. In the long term, persistent hyperglycaemia can damage eyes, kidneys, nerves and heart.

Two or three smaller meals during non-fasting is a safer way to avoid a blood sugar spike.

“Fasting during Ramadan is not easy and presents serious challenges for those with diabetes,” said Dr Bahaa Demian Grace, internal medicine specialist at Burjeel Medical Centre, Al Bahia.

“Patient and doctors need to be working together to adjust diet and medication in a safe way.

“UAE doctors are co-operating with UK doctors to share findings on how to manage a Muslim population with diabetes in both countries. Recommendations are being put in place and modified based on experience and evidence.”

In 2015, the International Diabetes Federation revealed almost one in five people (19.3 per cent) of the UAE population between the ages of 20 and 79 have Type 2 diabetes.

Government health initiatives aim to cut that to 16 per cent by 2021.

“Diabetics who have been diagnosed for years know how to control their condition, but newly diagnosed patients need extra care,” said Dr Dinesh Kumar Dhanwal, consultant endocrinologist at NMC hospitals.