Are you dwelling with diabetes and planning to quick for Ramadan? Comply with these sensible ideas and recommendation so you possibly can take pleasure in a protected and wholesome Ramadan.
Fasting, refraining from utilizing medicines, insulin and ingesting water will have an effect on your blood glucose ranges (BGL) and may result in potential dangers together with excessive BGL (hyperglycaemia), low BGL (hypoglycaemia or hypo), dehydration, blood clots and diabetic ketoacidosis (DKA).
Based on spiritual tenets, fasting isn’t meant to create extreme hardship on a person. It’s a commendable religious apply nevertheless it’s one that may include well being dangers for folks dwelling with diabetes. You might be suggested to not quick in case your diabetes administration is unstable previous to Ramadan, when you’ve got sort 1 diabetes, if you’re hypo unaware, pregnant, unwell, or can be performing intense bodily labour.
When you’ve got compilations related to diabetes, akin to coronary heart illness, kidney illness or visible issues, the danger of those points changing into worse throughout the quick is excessive, and so it is best to contemplate not fasting.
When you’ve got sort 2 diabetes and are handled with metformin, thiazolinediones or weight loss program alone, and in case your blood glucose is properly managed, you might be at low danger of issues with fasting.
The choice to quick is private, and your well being care group has an obligation of care to respect your dedication and guarantee your security.
A pre-Ramadan evaluation is a chance to overview your blood stress, BGL and lipids, be taught of any potential dangers of fasting, focus on monitoring and deal with a hypo or handle excessive BGL, and prescribe any Ramadan-specific adjustments within the dose and/or timing of your remedy or insulin regime.
Keep in mind a hypo is a medical emergency and remedy means you’ll need to interrupt your quick. Visiting your physician to regulate your insulin regime earlier than you start fasting might help you keep away from this.
Security tip: By no means cease taking your insulin or your diabetes medicines. Converse along with your diabetes physician or nurse about change the time and dose throughout Ramadan.
Checking your BGL extra incessantly is inspired throughout Ramadan, significantly in the event you take insulin or are on any sulfonylureas.
The Diabetes and Ramadan Worldwide Alliance affirm that pricking the pores and skin for blood glucose testing doesn’t invalidate the quick.
Security tip: When you really feel unwell at any time throughout Ramadan, test your BGL and be ready to interrupt the quick to deal with a hypo (BGL lower than 4mmol/L) – or handle hyperglycaemia (BGL greater than 15mmol/L).
Throughout the month of Ramadan your consuming sample can be affected by lengthy gaps between meals and feasting after iftar that may result in higher swings in blood glucose ranges. Good diet is especially necessary right now and sustaining a wholesome consuming plan will enable you to keep away from the overeating of carbohydrates and fatty meals on the sundown meal.
- Let your predawn meal (suhoor) be the most important one.
- Embody advanced carbohydrates akin to multigrain/wholegrain, sourdough breads, porridge, oats, bran, barley, semolina and buckwheat to present you sustainable vitality all through the day.
- Embody protein wealthy meals akin to lean meat, poultry, fish, eggs, dairy merchandise, seeds, nuts, beans, legumes and tofu.
- Drink loads of fluids, and select fluid-rich meals to be sure to are properly hydrated for the day.
- Break your quick with a ‘sundown snack’ of 1 date, a cup of water and a bowl of soup. This can present an prompt increase of vitality and hydration to assist settle your starvation and stop overeating at first of your fundamental meal.
- Attempt to eat slowly and chew properly to forestall overeating.
- Use the wholesome plate mannequin as a reminder: 1 / 4 of your plate must be advanced low GI carbohydrates akin to low GI rice, legumes and candy potato, an additional quarter of your plate must be lean meat, skinless rooster, egg, fish or tofu; the ultimate half of your plate must be greens or salad.
- Attempt to keep away from fried and salty meals at iftar.
- Ensure you drink loads of fluids – attempt to drink two cups each hour to stay hydrated.
Two hours after the dinner meal, it’s regular to really feel hungry. Have a wholesome snack to keep away from overeating or overindulging in conventional sweets. Keep away from sugary meals as they don’t offer you sustainable vitality. Fried meals might also make you’re feeling sluggish.
Some wholesome selections embrace:
- One or two items of contemporary fruit
- Canned fruit in pure juice (drained)
- Vegetable sticks with a tablespoon of hummus, tomato salsa or yoghurt dip
- 100-200g of low fats yoghurt
- A cup of low fats milk or soy milk (calcium fortified)
- 1-2 cups unbuttered and unsalted popcorn
- A handful of plain uncooked unsalted nuts
- A slice of grainy bread with a skinny unfold of avocado, low-fat ricotta, cottage cheese or hummus, with sliced greens.
You may proceed to do your regular bodily exercise. Nonetheless extreme bodily exercise must be prevented as this will improve your danger of hypoglycaemia, significantly throughout the few hours earlier than the sundown meal.
Taraweeh (a number of prayers carried out after the sundown meal which contain repeated cycles of rising, kneeling, and bowing) generally is a tiring exercise and you could possibly turn out to be dehydrated or be liable to hypos. To keep away from issues throughout Taraweeh, be sure to:
- Eat starchy meals with iftar as they’re digested slowly
- Drink loads of water following iftar
- Take a bottle of water and glucose remedy with you to taraweeh.
Basal (typically additionally referred to as background insulin, lengthy or intermediate-acting) insulin doses could must be diminished by round 15-30%. It’s best taken after iftar.
Bolus (mealtime, fast or short-acting) insulin doses shouldn’t be taken at lunchtime. The suhoor dosage could must be diminished by round 25-50%. Normally the common bolus dosage could be continued at iftar, offered you may have an identical sized meal as you’d normally have at dinner.
When you take premixed insulin as soon as each day the dosage could be taken at iftar. For these taking twice each day premixed insulin, the suhur dosage will must be diminished by round 25-50%. If you’re normally on three numerous premixed insulin at fundamental meals, the lunchtime one shouldn’t be taken. The iftar and suhoor doses will must be adjusted.
When you’ve got sort 1 diabetes and you might be on an insulin pump, typically the basal charges will must be diminished by 20-40% within the final three to 4 hours of fasting. It’s best to improve your basal charges by as much as 30% after iftar. Regular carbohydrate counting and insulin sensitivity rules apply with reference to bolus doses at each suhoor and iftar.
Notice: The above remedy and insulin dose adjustment suggestions are a suggestion solely. It’s best to all the time search recommendation out of your physician prior to Ramadan with reference to any remedy adjustments that could be wanted.
Diabetes Educator and Accredited Practising Dietitian Shannon Lin
Accredited Practising Dietitian Lina Breik
Accredited Practising Dietitian Dyala Al Jabi
Up to date February 2025
