Ramadan poses risks for diabetics

Patients with the condition are urged to consult doctors on how to fast safely.

ABU DHABI // Doctors have warned diabetics to take extra care of their health during Ramadan due to the risks of fasting with the condition. If done improperly, low blood sugar during the day, followed by a sharp increase at night, can trigger a diabetic attack. "People with diabetes can fast during Ramadan. It depends whether you are taking insulin or you are taking tablets," said Dr Abdulrazzaq al Madani, an endocrinologist and head of the Emirates Diabetes Association.

"If you are taking tablets and maintaining your diet, you can fast without any problem provided that you have controlled your blood sugar properly before the month of Ramadan. For this reason, diabetes sufferers must seek the advice of their doctor, prior to fasting, to help them adjust their medication and diet." The UAE has the second-highest incidence of diabetes in the world, more than three times the global average. According to a study from UAE University, diabetes affects 24.5 per cent of the population, while another 10 per cent are not aware they have the condition.

There are stark differences between the needs of a patient with Type 1 diabetes and a patient with Type 2. Dr Maha Barakat, the medical and research director of the Imperial College London Diabetes Centre in Abu Dhabi, says patients with Type 1 diabetes "always need enough insulin in their body throughout the day and night". They should "never be tempted to stop their insulin and must liaise with their doctor regarding how to adjust their doses and regimes for Ramadan".

Dr Madani suggested that people with Type 1 diabetes should not fast during Ramadan, but said people with Type 2 could fast if they managed their blood sugar appropriately. "All patients with diabetes should avoid eating high-sugary food and food where the carbohydrate component is in the fast-release form, otherwise known as high-glycaemic index," said Dr Barakat. "High-glycaemic index starchy food includes potatoes and white bread. Patients should also avoid getting dehydrated and should try to drink enough water - never sugar-containing drink - from the time of Iftar to just before Fajr."

Both doctors stressed the importance of hydration, especially in the summer heat. People with diabetes should take care to avoid sugary drinks, even the naturally occurring sugar in juice, and should rely only on water. "If untreated, dehydration from not drinking water during the day and then breaking fast on sugary food or drink will result in a state of high blood glucose levels that may require hospital treatment," said Dr Barakat. "The same applies to undiagnosed type 1 diabetes, but the presentation tends to be more acute."

One of the dangers during Ramadan is people who are diabetic but do not know it, which is about one in 10. A lack of food during the day followed by a feast at night can produce a spike in blood sugar, which could lead to a hospital visit or even a diabetic coma. "All people who experience symptoms of diabetes - increased thirst, frequent passing of urine and fatigue - should have a blood test to rule out diabetes," said Dr Barakat. "Furthermore, people should be especially vigilant for these symptoms if they have risk factors for diabetes."

These include a family history of the disease, lack of exercise and being overweight. @Email:[e-mail]