Diabetes in the Holy Month of Ramadan

Dr. M.K. Abedi

Why are we here today?

Islam is the second largest religion in the London Borough of Enfield.

Diabetes is most common amongst Asian patients.

This year Ramadan is expected to begin on 28th June 2014 at the sighting of the new moon

Ramadan will end on 28th July 2014

Diabetes and Ramadan Diabetes is a condition in which the amount of

glucose (sugar) in the blood is too high because the body cannot use what we eat properly.

During the Holy Month of Ramadan people change their eating habits. This may affect blood glucose levels in a way that can make some people feel very unwell.

We are here to give you information on how to stay well.

Fasting in 2014

This year you will be fasting for up to 19 hours July may also be very hot Peak temperature in London is 300 C ( 900 F) Average temperature in London is 220 C (700 F)

If you have diabetes

You need to make an appointment to see your General Practitioner or Practice Nurse

What needs to be considered: What treatment are you on? Has your health been generally good in the last year? Are your blood glucose levels generally well controlled? Do you have diabetes complications? How have you managed during Ramadan before and

how have you felt?

If you have diabetes who should not fast?

If you have recently been diagnosed If you have Type 1 or Type 2 diabetes that is not well

controlled If you have hypo unawareness If you are elderly or frail If you have a history of diabetic ketoacidosis If you have been having recurrent infections If you have kidney problems If you have had problems fasting before If you have unstable epilepsy

What are the risks of fasting for Ramadan if you have diabetes?

HypoglycaemiaLow blood glucose levels

HyperglycaemiaHigh blood glucose levels

DehydrationLack of fluid in the body

Symptoms of Hypoglycaemia orLow blood sugar

These vary from person to person

Confusion Dizziness Drowsiness Headache Hunger

Fast heart rate Sweating Weakness Feeling jittery Irritability

Causes of hypoglycaemia

If you take insulin, you may have taken too much Lumpy injection sites You may have reduced the amount of

carbohydrate in your diet You may have delayed or missed a meal Increased stress levels Increased your physical activity Hot weather can affect some people Some drugs can cause hypoglycaemia

Treatment for hypoglycaemia

Check blood glucose level if possible Eat or drink something sweet

Lucozade 50 – 100 mls Or Coke 50 – 100 mls (NOT DIET COKE) Or 3 – 6 glucose tablets Repeat if symptoms are not resolved after 5 – 10

minutes

When feeling less unwell, eat your next meal or have a snack like a sandwich or a banana

If you are getting episodes of hypoglycaemia you will need to visit your GP

Symptoms of hyperglycaemia or high blood sugar

Weight loss Increased thirst and dry mouth Tiredness Blurred vision Headache Loss of concentration Frequent urination

Causes of hyperglycaemia

You have stopped your medication You are taking the wrong dosage of your

medication You have reduced the amount of activity that you

do You have changed your diet

Treatment for hyperglycaemia

Take correct dosage of medication at the correct time

Take regular physical exercise Avoid changes to healthy eating plan See your GP if symptoms persist

General precautions for Ramadan

Plan your meals carefully Do not skip meals Avoid over eating at Iftar or Sehri Continue to take your medicines as prescribed by your

doctor If Type 1 diabetes check for ketones if blood glucose

level is high (>14 mmols) Drink plenty of sugar free drinks Know who to contact if in an emergency

Your Diet

If breaking fast with dates and milk, if diabetes is present dates should be limited to a maximum of 3

Limit or avoid sweets and fried foods at the start and break of your fast

Try to fit in 5 portions of fruit and vegetables a day Fill up on starchy foods like rice, chappati, couscous,

wholegrain bread Eat foods higher in fibre as these are more filling and

can prevent constipation Drink lots of fluids before fasting commences

Medication

There are leaflets available today that will give you further guidance about your medications for diabetes and how fasting may affect how they work

If you are concerned about your tablets, contact your GP or Practice Nurse.

Other possible health problems during Ramadan

Headache: Try to eat foods that have a slower absorption rate

e.g. grains and pulses.

Constipation: Drink plenty of fluids and eat foods that are high in

fiber.

Indigestion: Reduce fried foods and eat smaller portions at a time.

We wish you all a healthy Ramadan