03 May Diabetes in Ramadan: How to Speak With Your Doctor To Determine If you Can Fast 

How to Speak With Your Doctor To Determine If you Can Fast 

Summary! The decision to fast must be considered carefully as you do not want to worsen your health conditions as a result. It is important to seek expert advice by opening up the dialogue with your doctor about fasting. This article provides detailed tips on how to start that conversation and what resources you can provide.

In order to determine your ability to fast, use the following guidelines to engage in a productive dialogue with your doctor:

1. Share with your doctor what Ramadan fasting entails: If your doctor is not aware of Ramadan, avoid feeling misunderstood or unsupported by sharing with your doctor your desire to fast in Ramadan, and the conditions in which you will be fasting.
   • • Tell your doctor how many hours you will be fasting from Suhoor to Iftar – remember there is a big difference between a 10-hour fast versus an 18-hour fast for a patient with diabetes!
     • Inform your doctor that you cannot eat OR drink during this time,
2. Share with your doctor new research guidelines pertaining to diabetes management in Ramadan: Print out and bring the following Peer-Reviewed Article in the Journal of Family Medicine and Primary Care on physician treatment and management guidelines for patients with diabetes to your appointment, or send to your doctor before-hand. This article will help your physician use the latest medical guidelines to inform your diabetes management during Ramadan.
3. Understand the medication you are on: Your medication has a big impact on your ability to fast in Ramadan. Ask your doctor questions to help you understand your treatment options in Ramadan:
   • • Can your medication cause your blood sugar to go very low? In which case your doctor may reduce your medication dosage during Ramadan.
     • Ask your doctor: “If I decrease the amount of Insulin I am taking, will I be able to fast?” This question will elicit a good conversation to assess the potential risk of fasting for your diagnosis – also an effective exercise plan can naturally reduce your need for insulin medication
4. Ask what lifestyle interventions, such as healthy eating and exercise you can engage in to have a more successful Ramadan:
   • • Your doctor may refer you to a dietitian to help you ensure your food intake in Ramadan is healthy and safe for a patient with diabetes
     • Exercise can improve insulin sensitivity and improve your prognosis for fasting in Ramadan. Speak to your doctor about how you can improve your condition using physical exercise and make it a goal to improve your health by next Ramadan to be able to fast in a safe, healthy way!
     • Kidney function can be improved in overweight patients after weight loss. Safe weight loss may allow a patient to fast safely in future Ramadans!
     • Ensure your family is aware of your unique needs as a patient with diabetes. If your family is on board with preparing and eating diabetic-friendly, low carb meals, you are much more likely to avoid complications while fasting.
5. Ask your doctor about monitoring & managing complications: 
   • • Self-monitoring of blood glucose levels is essential in safe management of diabetes in Ramadan. Discuss with your doctor how often you should be checking your blood sugar.

• Self-monitoring of blood glucose (SMBG) in Ramadan is an important tool during Ramadan for people with diabetes to provide the information about glucose variability, which can lead to detection and prevention of hypoglycaemia as well as hyperglycaemia. This can also certainly help in behaviour change of diet and physical activities during Ramadan. The frequency of monitoring would depend on the type of treatment, the glycaemic control and the lifestyle of the individual. 

• It is also recommended for all people with diabetes to help detect postprandial hyperglycaemia, which is not unusual in many people with diabetes during Ramadan. (5)

• • • Involve & Educate your family in being able to recognise symptoms of hypoglycaemia, hyperglycaemia and dehydration. A patient’s family should recognise these symptoms as the patient’s judgement may not be sound during hypoglycaemic incident. Bring your spouse to your medical appointment to ensure you have family support during Ramadan. If symptoms arise, you and your family must be prepared to help you break your fast immediately.

REFERENCES

5. Hassanein, M. (2015). Ramadan focused diabetes education; a much needed approach. J Pak Med Assoc, 65(5 Suppl 1), S76-S78.