Ramadan Fasting and Its Health Benefits
adjusted appropriately. Potential risks associated with fasting and diabetes are disturbance in glycaemic control manifesting as hypoglycaemia and hyperglycaemia which is not good. In addition metabolic emergencies, such as diabetic ketoacidosis (DKA), hyperosmolar hyperglycaemic syndrome (HHS), dehydration, renal impairment and hypotension and thrombosis secondary to hyperglycaemia and dehydration can also occur . Further, cardiometabolic factors such as blood pressure and lipid profiles may also be subject to changes during the Ramadan fasting.
A patient’s decision to fast should be made after ample discussion with his or her healthcare provider, with informed discussion on the risks involved, adjustment of the medications and the recognition of “red-flag” signs. Like the usual management of diabetes, the management plan must be individualized. Patients classified as very high or high risk, including those with Type 1 diabetes and pregnant women with diabetes need close medical supervision if they insist on Ramadan fasting. This group however has been exempted from fasting as per the Islamic guidelines and need to be counselled accordingly because of risks involved.
Acknowledgement: The scientific help rendered by Dr S K Wangnoo, Consultant Endocrinologist, Apollo Hospital in writing this article is greatly appreciated.