Diabetes and Fasting in Ramzan ( Roza )

Ramadan is a lunar-based month, and its duration varies between 29 and 30 days. Its timing changes with respect to seasons. Depending on the geographical location and season, the duration of the daily fast may range from a few to more than 20 h. Muslims who fast during Ramadan must abstain from eating, drinking, use of oral medications, and smoking from predawn to after sunset.

Fasting is not meant to create excessive hardship on the Muslim individual. The Koran specifically exempts the sick from the duty of fasting (Holy Koran, Al-Bakarah, 183–185), especially if fasting might lead to harmful consequences for the individual. Patients with diabetes fall under this category because their chronic metabolic disorder may place them at high risk for various complications.

Usally, person with diabetes are advised to avoid from overeat. Medical specialist usally advise to the diabetic persons to take 3 to 5 meal in a day. It is a common princle in diabetes.
But there are some  axempt situations where a special princpal should adopt like fast in ramzan. In ramzan the muslims must have to avoid to eat or drink during fast timing in respect of fast and Ramzan, because in Islam during fast the eating, drinking and sex is haram. On the other hand avoid to eat or drink for the long time 10 to 12 hours is a dangrous situation, for a person having diabetes. The risk of hypoglycemia increase because of fasting for the long time. So There is often discussion about whether people with diabetes should fast during Ramadan or not. Ramadan is a month long period of fasting during the daylight hours.

Fasting during Ramadan is undertaken to promote chastity and humility and as an act of submission to Allah.

Is fasting with diabetes dangerous to health?

The persons whose are on blood glucose lowering medication should consult their doctor about whether it will be safe for them to fast and what precautions can be taken to prevent blood glucose levels from going either too low or too high.

Continuing to take blood glucose lowering medication during the daylight hours of fasting may present a particular risk of low blood glucose; hypoglycemia.At the time of Iftar, due to fasting whole day the people feel very hunger and the body may need to take in more food than would normally. 

In aftari mostly people eat the food in large scale diabetic and non diabetic persons. Eating large scale people having diabetes is very risky, it can may increase the blood sugar level. As a result, this may lead to higher blood glucose levels during the night time hours.

Should people with diabetes fast during Ramadan?

People are recommended not to fast if the act of fasting could negatively affect their health.
In the Quran kareem Allah Taala had said;

People with type 1 diabetes should not stop taking their insulin as this could lead to a dangerous condition called diabetic ketoacidosis. However, fasting whilst continuing to take insulin could lead to hypos so people with type 1 should seek the advice of their consultant or diabetologist before taking part in fasting.

In this difficult situation it is best to consult with doctor and religious scholar about how best to respect the fasting period. Be sure to consult with you doctor if you take part in the fast.

How to keep control blood sugar level in the fast of Ramzan?

Controlling your blood sugar levels through Ramadan

Increase or low blood sugar level in normal life and in Ramazan specially is very dangerous situation, so it is advisable diabetic to test his blood sugar levels more often than normal through Ramadan.

keep check on his daily changes in body and behavior and be aware of the symptoms of high and low blood sugar. If you are taking blood glucose lowering medication, make sure you have a form of quickly absorbed sugar with you.

Ramadan: Fasting principals and things to Avoid

Here are some food tips that diabetics should follow during Ramadan

Keep monitoring the blood sugar level

Frequent monitoring of blood sugar level is key to safe fasting for diabetics. It is critical for patients to monitor their blood sugar level multiple times through the day.

Avoid to over eat

Do not overeat. One of the main reasons behind Ramadan fasting is to learn to curb your desires and tune in to Allah and pay attention to body signals and understand hunger.

Avoid to  drink or eat sugar base things

At Iftar, break your fast with sugar-free and decaffeinated drinks to rehydrate your body and avoid dehydration.

Use Limited sugar

Limit the consumption of sweets during Ramadan. Include fruits, vegetables, pulses and curd in your diet.

Do not sleep soon after your dinner; allow an interval of 2 hours. 
Avoid complex carbs right before bedtime.

Ensure right nutrient intake at the time of Sehri. Suggested items include whole grain bread, whole grain low sugar cereals, beans and lentils.

Avoid deep fried foods such as paratha, puri, samosa, chwera and pakoras. Starch containing items such as rice and wheat chapatti can be consumed. 

What are the main things to remember if you're diabetic and are fasting for Ramadan? 

1- Consult your doctor before you decide to fast to understand the state your body will get into. • If you still want to fast, understand the risks completely by reading or talking to people. 

2-  Plan your meals and the type of meals for each day, and incorporate foods that will keep you full for longer. 

3- Alter timings for your medications to avoid hypoglycaemia. 

4-  Regularly check your blood sugar levels to avoid any unseen complications. 

5- Keep yourself hydrated and avoid caffeinated or sugary drinks. 

6- When breaking a fat, avoid large quantities of food. Not all bodies are same and not all diabetics get affected the same way. Some of them can fast without any risks to themselves. 

But just because you know someone with diabetes, who has been successful at fasting, it does not mean you can assume the same for yourself. 

There is also not enough literature available to understand what this type of fasting can do to diabetic patients. So, if you see fatal signs during your fasting period, it is best to stop. 

Some complications in Ramazan with Diabetic Patients

In Islamic pricipals there are some special conditio where some type of exemptions apply like fasting exempt in acute condition. persons with svere diabetes are exempt from fasting according to the Quran but for personal satisfaction, some people go ahead anyway without realizing they are putting themselves into the various risks. 

 Individuals with diabetes are exempt from fasting, according to the Quran, but for personal satisfaction, some people go ahead anyway, without realizing the various risks they are putting themselves into. 

Some major risks of Ramadan fasting include 

1. Hypoglycaemia (Low blood sugar )

low blood sugar levels: This is most probable in patients consuming medicines for diabetes. It's best to refrain from excessive physical activity during the fasting period.

2. Hyperglycaemia ( high blood sugar level )

This is probable if you overeat a meal due to the hunger when the fast is broken. Evening meals in many houses are considered a massive celebration, which sometimes involves overindulgence in food. Thus, consuming moderate quantities of food is advised. 

3. Dehydration

This becomes a big problem for all who fast and are out all day. The summer seems to worsen this situation. More fluids with less sugar and caffeine are encouraged. 

These risks are higher for patients suffering from diabetes. This is because of the fluctuating blood sugar levels and the tablets or insulin they consume. It is definitely not advisable to stop medications for diabetes for the fear of having hypoglycaemia. 

The only tweak that should be made is the timings at which the medicines are consumed. Because not taking the medications also puts you at a risk of hyperglycaemia after large pre-dawn or post-sunset meals.

ketoacidosis

Patients with diabetes, especially those with type 1 diabetes, who fast during Ramadan are at increased risk for development of diabetic ketoacidosis, particularly if they are grossly hyperglycemic before Ramadan. In addition, the risk for diabetic ketoacidosis may be further increased due to excessive reduction of insulin dosages based on the assumption that food intake is reduced during the month.