Ramadan 2019: don't skip medication during fast if it risks your life, doctors say

Diabetics, asthmatics and epilepsy patients are among those most likely to skip prescription drugs during Ramadan

Dr Fadi Baladi, medical director, and Michael Ghani, director of operations, of the Burjeel Day Surgery Centre in Abu Dhabi. Victor Besa / The National 

People who skip necessary medication while fasting during Ramadan are putting their lives at risk, with hospitals seeing an increase in admissions around this time each year, doctors have said.

Reducing the dosage of required medication and attempts to self-medicate without seeking professional advice have also led to a deluge of clinical visits in previous years.

The most common admissions are of people with chronic conditions such as diabetes, hypertension, asthma and epilepsy.

“Medication is treated in the same way as food, so some patients do not take their medication when they fast,” said Dr Fadi Baladi, a medical director at Reem Island day surgery.

“This is a big problem … It is dangerous, especially for type 1 diabetics who need insulin to function normally.

“There is a misconception that their diabetes is related to calories, so if people are fasting they do not need their medication. This is not accurate. It is risky, and disastrous.”

During Ramadan last year, the Reem Island clinic extended the availability of specialists by an extra two hours a day to deal with the increased demand for treatment outside of hospital hours. Patients often fall ill after breaking their fast at sunset and many of the cases they saw were medication related.

The surgery are preparing for a similar extension of hours this year.

With Ramadan having in recent years fallen during the warmer months, the triple threat of rising temperatures, air-conditioned environments and the occasional dust storm can ramp up the risk of asthma sufferers having an attack. Yet fasting asthmatics told doctors that they would not use their regular steroid inhalers, which helps reduce lung inflammation, during daylight hours last year.

Doctors also said they see an increase in epileptic seizures during the Holy Month, even from patients who have not had one for a significant period of time.

“These patients need to have a certain level of drugs in their system at any given time to reduce the impact of their symptoms and control seizures," said Dr Baladi.

Diabetics and anyone who takes regular medication should check with their regular doctor to ensure it is safe to fast, with opinion varying among the medical community about whether it is safe for children to fast at all.

“It is important that children who observe the Ramadan fast do so under strict parental supervision and dietary modifications,” said Dr Alaa Takidin, a nutritionist at the Canadian Specialist Hospital, Dubai.

“Children should start with partial fasting, especially if they are doing it for the first time, and then gradually increase the duration.”

She recommended that fasting children go to bed early so they are less sleep deprived in school as they will be waking up early for suhoor, the pre-sunrise meal.

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Foods rich in proteins, such as peanut butter, low-fat cheese, labnah, yoghurt and milk, are advised for breakfast.

Beans, lentils, lean meats, nuts, oatmeal, eggs and dairy products are also good sources of protein, and fibre intake can be increased through fruit and vegetables, wholewheat bread and cereals.

It is also recommend that children break up their iftar, or post-sunset meal, into two smaller and more manageable meals to avoid over eating.

“Fasting should only be allowed for children who are healthy and where it would not interfere with medical treatment,” said Dr Ramsey Mustafa Al Omari, a consultant paediatrician at the Canadian Specialist Hospital.

Children should stop fasting altogether if they show any signs of sickness or lethargy. And with eating disorders on the rise, parents should pay extra attention to any unusual eating habits that may disguise a related mental health issue.

Medcare Hospital in Sharjah said that they also saw an increase in urinary tract infections triggered by dehydration last year, as well as low blood pressure and gastroenterology issues.