Safe fasting for diabetics: 3 pillars and medical advice for Ramadan

With the approach of the holy month of Ramadan, the medical and religious debate is renewed regarding the ability of diabetic patients to fast without facing health risks. In this context, Professor Abdulmu'in Eid Al-Agha, Professor and Consultant of Pediatric Endocrinology and Diabetes at King Abdulaziz University Hospital in Jeddah, affirmed that the concept of "safe fasting" is the ideal solution that combines fulfilling the religious obligation with preserving one's health. He pointed out that fasting can be healthy for a large segment of patients if strict medical guidelines are followed.

The medical context and the importance of advance planning

Diabetes is one of the most common chronic diseases in the region, making managing fasting a significant health challenge. The importance of this topic lies in the need to avoid serious complications such as diabetic ketoacidosis or severe dehydration. Professor Al-Agha explained to Al-Youm that healthy fasting is not simply abstaining from food, but rather a carefully planned process that requires adjusting the body's biological clock and medication schedules to align with fasting and non-fasting hours.

The three pillars of safe fasting

The consultant identified three main pillars upon which safe fasting is based, which serve as a roadmap for the patient:

• Close medical follow-up: This involves visiting the doctor before Ramadan to adjust doses and determine whether or not fasting is possible based on the patient's condition and cumulative blood sugar.
• Dietary commitment: Following a balanced diet that avoids simple sugars and saturated fats that are abundant in Ramadan meals.
• Continuous monitoring: Measure blood sugar levels periodically during fasting, and do not rely solely on physical sensations, as a drop in blood sugar may occur suddenly.

When should one break their fast immediately?

Professor Al-Agha stressed that preserving one's life takes precedence over fasting, specifying cases that necessitate breaking the fast immediately and without hesitation, which are:

• Low blood sugar (less than 70 mg/dL) or very high blood sugar (more than 300 mg/dL).
• Symptoms of acute hypotension may include dizziness, cold sweats, tremors, heart palpitations, or blurred vision.
• Severe dehydration, vomiting, or any sudden illness may worsen the condition.

The role of modern technology in diabetes management

Regarding technological advancements, Al-Agha highlighted the pivotal role of electronic sensors and continuous glucose monitoring (CGM) devices. These devices have revolutionized blood sugar management during Ramadan, providing real-time readings and 24-hour graphs of blood glucose levels, and issuing warning alerts before reaching critical levels, thus giving patients ample time to make informed decisions, whether to adjust their dosage or break their fast.

Golden tips for a healthy Ramadan

The professor concluded his speech with a set of recommendations to ensure stable health throughout the holy month:

1. Delaying Suhoor: Make sure to delay the Suhoor meal as much as possible and make it rich in fiber and protein to ensure satiety and stable blood sugar for a longer period.
2. Good hydration: Drink sufficient amounts of water between Iftar and Suhoor to replace fluids and avoid dehydration, which increases blood viscosity.
3. Divide your meals: Do not eat a large breakfast all at once, but divide it to avoid a sudden rise in blood sugar.
4. Physical activity: Engaging in light exercise such as walking after Taraweeh prayers to improve insulin sensitivity and blood circulation.

The patient's health awareness and partnership with the treating physician are the cornerstones for passing through the month of Ramadan safely, healthily and well.