Muslims with health conditions such as diabetes are exempt from the obligation to fast, but that doesn’t stop many from wanting to join friends and family during Ramadan.
During Ramadan, the ninth month of the Islamic lunar calendar, adult Muslims are required to refrain from taking any food, beverages or oral drugs between dawn and sunset.
Doctors are warning Muslims around the world, especially those with with pre-existing conditions, to watch out for certain health risks during this time, above all relating to how you take medicine and handle diabetes.
1. Watch how you take medication
Fasting affects the metabolism and medical experts say the body reacts differently to medication as a result.
Two examples: Diuretics, or water pills, are used to treat high blood pressure and heart failure. If you are fasting and not drinking during the day, you should adjust the dose of your medication. Otherwise, there is a risk of dehydration, as the body loses too much water.
Blood pressure medication with the active ingredient lercanidipine is generally supposed to be taken before meals. However, if during Ramadan you swallow the tablet after a hearty meal after sunset, the effect is intensified, your pharmacist will tell you.
Germany’s Union of Pharmacist Associations ABDA is asking Muslims to be on the safe side and get medical advice in advance and/or discuss the topic at the pharmacy. These pharmacists advise against changing the dosage or simply skipping medication on your own during Ramadan.
Although taking medication is not allowed during the day in Ramadan, there are noteworthy exceptions, including inhalers, ointments and eye drops.
It may be possible to switch to a different form of administration during the month of fasting – this should also be clarified in advance.
2. Diabetics: Don’t fast until your sugar levels crash
Not all diabetics are the same and some people with the metabolic disorder have a high or even very high risk of complications in Ramadan.
This applies to all people with type 1 diabetes, whom doctors generally advise against fasting. This is because the long break from eating during the day can cause dangerous fluctuations in blood sugar levels, and the risk of severe hypoglycaemia is high.
Those who still want to fast should do so under close medical checks and with continuous measurements of their blood sugar levels.
People with type 2 diabetes, on the other hand, can fast provided their health risk is low. However, they should also consult their doctor in advance – also to clarify any possible adjustment of medication. And of course, they should also check their blood sugar level regularly throughout the day.
If their blood sugar level gets out of control, diabetics should stop fasting immediately. Symptoms such as tremors and dizziness indicate hypoglycaemia, and a blood sugar level below 70 mg/dl is also a warning sign.
Hyperglycaemia is indicated by frequent urination, tiredness, confusion and nausea, as well as a blood sugar level above 300 mg/dl.
Diabetics in particular should heed their doctor’s advice regarding altered mealtimes. When at risk of a medical emergency, Muslims are permitted to break their fast. Diabetics, for example, can consume glucose to prevent hypoglycaemia and should continue to check their blood sugar levels several times daily.
3. Eat a long-lasting suhur and beware the sugary iftar
Iftar – the meal after sunset – is often characterised by sweet and fatty foods. If you have diabetes, it is best to avoid Iftar staples like baklava and sweet drinks.
For a stable blood sugar level, it’s best to keep to wholemeal products, legumes, vegetables and lean proteins.
For suhur, the meal before sunrise, try to pick foods that are high in fibre and will keep you feeling full for longer. Oats or wholemeal grains are a good choice here. A lightly salted soup can also help you get through the day without fluids but still stay healthy.
