The holy month of Ramadan is one of the important months for whole Muslim world. It is a lunar-based month, and its duration varies between 29 and 30 days. Muslims who fast during Ramadan must abstain from eating, drinking, use of oral medications, and smoking from predawn to after sunset; however, there are no restrictions on food or fluid intake between sunset and dawn. Most people consume two meals per day during this month, one after sunset (iftaar)and the other before dawn(suhoor).
Fasting during Ramadan is ordained to be a duty for all healthy Muslim adults. Although it is not necessary for ill persons. In fact the Holy Quran states that there are groups of people who do not have to fast, especially if it puts their health at risk. This includes children, pregnant or breastfeeding women, the elderly and anyone who might make themselves ill by fasting. This also includes people with poorly controlled diabetes, people with type 1 diabetes who take insulin or type 2 on a mixed insulin regimen or those who often have very high or very low blood glucose levels. However, there are millions of Muslims with diabetes who still observe fast during Ramadan. Many people with diabetes can observe fast safely during Ramadan. A recent survey in 39 countries involving over 38,000 Muslims reported that a median of 93% fasted during Ramadan . The Epidemiology of Diabetes and Ramadan (EPIDIAR) study performed in 2001 found that 42.8% of patients with type 1 diabetes mellitus (T1DM) and 78.7% of those with T2DM fasted for at least 15 days during Ramadan.
What happens during Fasting: During a fast, at about eight hours after your last meal, your body starts to use energy stores to keep your blood glucose (sugar) levels normal. For most people this is not harmful, but if you have diabetes, your body cannot use the glucose as well as it should. With diabetes – especially if you take certain tablets or insulin – you are at risk of hypoglycaemia (low blood glucose levels). Ramadan fasting not only alters the timings of meals but it may also disturb sleeping patterns and circadian rhythms, all of which can affect a person’s metabolic state. Understanding these changes can help with the management of diabetes during Ramadan. The impact of fasting on glucose homeostasis is of particular importance when considering the risks to people with diabetes.
Consequences: Fast during Ramadan by people with complicated diabetes may cause certain problems like hypoglycemia (decrease in blood glucose level), hyperglycemia (increase in blood glucose levels), dehydration and diabetes ketoacidosis. During fasting time, patient may suffer from hypoglycemia due to lack of glucose while after evening people might encounter increased glucose levels due to excessive intake of food.
Another challenge that can occur if you have diabetes, is the risk of high sugars following the larger meals that you eat before and after fasting (at sehri and iftar), which can lead to health problems in the short and long term. As no food or drink is taken during the hours of daylight, the time between meals during Ramadan is much longer than in other months of the year. Changes in sleep and food intake impact on circadian rhythms; several changes have been noted, including changes in body temperature and cortisol levels. In healthy individuals, increased glucose levels in the blood after eating stimulates insulin secretion, which triggers the liver and muscles to store glucose as glycogen.
REFERENCE:
May 31 2017.Diabetes and Ramadan.Greater Kashmir.retrieved from
http://www.greaterkashmir.com/news/opinion/story/250981.html
