Ramadan and Diabetes
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As you know, Ramadan is the Holy Month for Muslims - a time of worship, self-discipline, austerity and charity. Fasting is necessary for all healthy adult Muslims, nothing being consumed between dawn and sunset.
Alterations to mealtimes, daily routine and use of special traditional foods occur during the Holy Month. People who are Muslim and have diabetes can be exempted from fasting. But you may wish to fast.
Fasting could cause problems for you if you have diabetes as your health is closely linked with diet, meal timings and medications. But having diabetes does not mean you cannot fast. This information gives you guidelines on what to do if you do want to fast, so that you can do so safely.
If you are in any doubt about what you should do with your treatment while fasting, contact your diabetes nurse or doctor or GP.
Group 1: People controlling their diabetes by diet and exercise
If you control your diabetes by diet and exercise, provided you continue to be careful with your diet, you can fast safely during Ramadan. If you are overweight, you can lose weight during the Holy Month, which can improve your diabetic control.
You may feel tired when fasting during Ramadan, so although it is important that you continue your daily activity and prayer, try to rest at some point in the day.
Group 2: People controlling their diabetes with diet, exercise and tablets
It is important that you follow the same guidelines as Group 1 regarding diet and resting.
The following Diabetes medications may contribute to hypoglycaemia without the appropriate advice.
Taking METFORMIN or ACARBOSE
Taking GLICLAZIDE, GLIPIZIDE, GLIMEPIRIDE or GLIBENCLAMIDE (with or
Taking PIOGLITAZONE (with other tablets or insulin)
Dipeptidyl peptidase 4 inhibitors also known as gliptins
SGLT2 inhibitors (sodium-glucose transporter (2) inhibitors
Non insulin injections - Glucagon- Like Peptide (GLP-1)
If you are in doubt about what to do with your tablets or injections when fasting, discuss this with your diabetes nurse or doctor or GP.
Testing blood sugars when taking tablets and fasting
If your results worry you and you don't know what to do, contact your diabetes nurse or doctor or GP.
Group 3: People controlling their diabetes by taking insulin (with or without tablets)
It is important that you follow the same guidelines as Group 1 and 2 regarding diet and rest.
If you control your diabetes with insulin, it is vital that you know what to do when fasting to avoid high blood sugars (hyperglycaemia – more than 10) or low blood sugars (hypoglycaemia – less than 4).
Quick Acting insulin’s such as Novorapid, Humalog, Apidra and Long Acting insulin’s such as Lantus and Levemir provide a more flexible insulin regime, making it easier to change the timings of injections and alter doses.
Pre mixed insulins for example Novomix 30, Humalog mix 25 & mix 50 are not recommended during periods of fasting.
You will need the help of your diabetes nurse or doctor to change your insulin so contact them for advice well in advance of the next Holy Month.
If you fast and are taking insulin, it is important to check your blood sugar frequently to make sure you are not going 'hypo' (less than 4) or that your blood sugar is not rising too high (more than 10).
HYPOGLYCAEMIA (blood sugar less than 4) Hypoglycaemia leaflet
Signs and symptoms
IF YOU HAVE A HYPO WHEN FASTING, YOU MUST BREAK YOUR FAST OTHERWISE YOU MAY GO INTO A COMA
If you can test your blood sugar. Try to work out why you had a hypo
People at risk when fasting
The Quran allows you not to fast if you have an illness or medical condition and you can donate some money to charity. But if you really want to fast, make sure you can do this safely.
Contact your diabetes nurse or doctor or GP for advice about your treatment if you have any doubts.
For further information on Diabetes Medication refer to www.mydiabetesmyway.scot.nhs.uk/resources/leaflets/tablets.asp?ID=759&thesection=noninsulin&thetitle=Tablets&thetype=leaflet
For the Diabetes UK Ramadam leaflet click on the following link www.diabetes.org.uk/Documents/Guide%20to%20diabetes/Ramadan/fasting-ramadan-factsheet-english-0514.pdf
For further information on fasting, click on the facts about fasting site below: www.factsaboutfasting.com
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