Managing Diabetes During Ramadan
By Jasmine Kwan, Dietitian at Glyco Leap
Observed by Muslims worldwide, Ramadan is a month long period of fasting during the daylight hours. Fasting (sawm) is undertaken to promote chastity and humility and as an act of submission to Allah. This year, observing Muslims will celebrate Ramadan on the sunset of Sunday, the 5th of June, and continue for 30 days until Tuesday, the 5thof July.
Is it safe for people with diabetes to fast during Ramadan?
While the Qur’an requires Muslims to fast during the month of Ramadan from sunrise to sunset, there are exceptions to this. One of them is that people who are ill or have medical conditions do not have to fast (source: Office of the Mufti, MUIS, Singapore). This includes people with diabetes but to find out more about this, you should speak to your Imam.
The biggest concern for people with diabetes who fast during Ramadan is the risk of hypoglycemia (low blood glucose). In addition, the consumption of sweet and fried foods, prepared traditionally for Ramadan, especially with the evening break-fast meal (Iftar), may instead lead to hyperglycemia (high blood glucose).
If you choose to fast, you must consult your doctor before Ramadan, so that you are equipped with the proper knowledge and skills to fast safely.
How will a consult with my doctor help me decide if it is safe for me to fast during Ramadan?
Your doctor will be able to advice you on your current diabetes medication and insulin regimes. If you are on insulin, you may require a different type of insulin and/or less insulin before the start of the fast. Certain adjustments to your blood glucose-lowering medication may also be needed so you are at reduced risk of hypoglycemia (low blood glucose). They can also refer you to useful healthcare professionals like Diabetes Nurse Educators who will teach you how to check your blood glucose using a glucometer, and provide you with valuable information like proper treatment if your blood glucose becomes too low.
To help you reduce the risks of becoming ill during Ramadan if you decide to fast, here are 5 tips to help you fast healthily and safely this Ramadan:
1. Break your fast with 1 to 3 pieces of dates (kurma)
- After a long day of fasting, your blood sugar may be a little low. Breaking your fast with 1 to 3 dates may help to regulate sugar levels
2. Choose complex carbohydrates instead of refined carbohydrates
- Complex carbohydrates are digested slowly and result in a slower rise in energy and blood sugar levels
- Brown rice, wholemeal bread, brown rice vermicelli and oats are examples of complex carbohydrates
3. Have adequate fibre
- Start your meal with some fresh fruit and load up on vegetables
- High fibre foods provide the feeling of fullness and help reduce over-eating
- Fibre helps with blood sugar control as it slows down sugar absorption
4. Stay hydrated
- Break your fast by drinking plenty of water to help rehydrate your body and reduce the chances of over-eating
- Limit or avoid sweetened drinks as they raise blood sugar levels quickly and increase caloric intake
5. As a guide to healthy eating, follow the plate concept during the Sahur and Iftar period
- Fill 1/2 your plate with vegetables, 1/4 with protein foods (e.g. fish, chicken, tofu), 1/4 with starchy fods (e.g. brown rice), and include 1 serving of fruit
- Avoid second helpings of calorie-dense dishes like curries prepared with coconut milk (santan) or deep-fried ayam masak merah
- Eat slowly and stop eating once you feel about 80% full. Avoid picking up extra snacks