Muslims with diabetes face a number of health risks and need adequate preparation in order to fast safely during the month of Ramadan.
Otherwise, they may feel light-headed or even faint from hypoglycaemia, when blood sugar levels fall to abnormally low levels.
We ask experts to tackle some commonly asked questions.
1. Can diabetic patients monitor their blood glucose levels during Ramadan?
Yes, Muslims are allowed to check their blood glucose levels without having to break their fast. Blood glucose monitoring allows diabetic patients to make adjustments to their food and activities.
2. What are the ideal blood glucose levels during fasting and non-fasting periods?
Most diabetic patients should maintain an optimal range of 6 mmol to 8 mmol before meals and 7 mmol to 10 mmol two hours after meals. To achieve this, the morning dose of oral diabetes medication or insulin should be carefully adjusted to avoid both low and high blood glucose during the day.
3. Should diabetic patients exercise during Ramadan?
Why not? Exercise helps to reduce the fat in the body and improve the effects of insulin. But, as a general rule, you should not do strenuous exercise during the day time (during fasting) to avoid low blood glucose levels and dehydration.
4. What are the symptoms of hypoglycaemia?
Common ones include feeling hungry, shaky and breaking out in cold sweat. Later, the person may experience light-headedness, confusion or irrritability. If left untreated, it can lead to unconsciousness. Hypoglycaemia is an emergency and requires fast treatment. A blood glucose check can confirm hypoglycaemia, which registers at less than 3.9 mmol/L.
5. How do you handle hypoglycaemia?
Take 15 to 20g of fast-absorbing carbohydrates. Examples include a glucose drink, juices, syrup drinks or sweets. Repeat if the blood glucose level does not go beyond 4 mmol/L after 15 minutes. Food or snacks can be taken 15 to 20 minutes afterwards.
6. What should diabetics take note of when fasting?
Eat fibre-rich food, such as fruit, vegetables, beans and wholegrain products before fasting and when breaking fast. This is to maintain satiety and good sugar control. Also, do not skip the pre-dawn meal to avoid fasting for a longer period than necessary. And if you break your fast by eating dates, eat just one or two as they are high in sugar.
(Sources: Ms Noorani Othman, diabetes nurse educator, nursing service, and Ms Melissa Ho, a dietitian at the department of nutrition & dietetics, Tan Tock Seng Hospital.)
Get more tips in the upcoming issue of Mind Your Body, which comes with The Straits Times every Thursday.