Should Diabetics fast in Ramazan

Ramazan is coming and every body is palnning for fasting in this holy month. Should diabetics fast or not?

Diabetes is of two types:
1. Insulin dependent type: Those who take Insulin for diabetes
2. Non Insulin Dependent or those who take tablets for diabetes

For number 1 above as the insulin causes a fall in blood sugar so these patients need frequent food and are in danger of low blood sugar. These are therfore advised to continue their treatment and not advised to fast at all. They should cosult an ALIM for compensation.

For dibetics with obesity and overweight who are using Metformin (Glucophage, Neophage, Metphage etc) only they should fast. They should take their medicine only in the evening and should avoid sugars, syrups, sweet drinks or sugar containg sharbats. Aquavit by Wilson is a sugarfree satche which can be taken in Aftar instead of the above. They have a better chance of weight loss and diabetic control.

For thin and normal weight patients who are taking glibenclamide (Daonil, Euglucon etc) or the newer drugs like Amaryl,Getryl, Pioglitazones etc the options are:

1. If their sugar is normal or below 120 fasting or below 180 random, they should take half of their dose in Aftar only. No drugs in Sehri.

2. If the blood sugar is high ie fasting more than 160 or random more than 220 , they should take their full dose in the Evening in Aftar and no drugs in Sehri. Both groups should take modrate amouts of fruits in aftar.

SEHRI IS A MUST FOR BOTH GROUPS to avoid low blood sugar during the day.

NOTE: If symptoms and signs of low blood sugar develop (Cold sweats, dimmness of vision , drowziness, weakness and a low blood sugar test) they should discontiue ROZA and take some sweets immediately even if it is near to Aftar to avoid problems. They should not fast during the next 3-4 days and only start ROZA after consulting their doctors or with no medicine at all.