Mariecar Jara-Puyod, Senior Reporter
People with diabetes may still fast during the Holy Month of Ramadan with proper consultation and guidance with their diabetologists and/or endocrinologists.
This is to prevent four acute conditions brought about by “metabolic consequences of prolonged fasting combined with dietary changes and alterations to the dosage and timing of the medications,” Al Zahra Hospital-Dubai Endocrinology & Diabetes specialist Dr. Vikram Hundia said in an interview on Wednesday.
Hundia identified the complications as hyperglycemia (high blood sugars), hypoglycemia (mildly low blood sugars), severe hypoglycemia, and diabetic ketoacidosis (characterized by the insufficient amount of insulin to produce glucose and a warning sign that the diabetes is getting out of control and may lead to body poisoning).
“It is never too late to consult with your doctor on what to do and not to do for the rest of the Holy Month of Ramadan. But make a clear written plan with your Diabetes Team about any changes to your insulin or diabetes medication dosage and timing to maintain satisfactory diabetes control and avoid hypoglycemia or other diabetes-related complications,” he said.
Hundia added: “Check your blood sugar levels more frequently. Drink plenty of sugar-free fluids during the non-fasting times to avoid dehydration. Avoid caffein.”
He emphasized the role of the dietician.
Hundia’s colleague, Reshma Devjani was interviewed as well and while she offered healthy tips too, she also spent time dishing out menu samples for the diabetics.
Devjani pointed out seven causes why people with diabetes suffer from poor glucose control during the Holy Month of Ramadan, leading to the shoot up and/or prolonged high blood glucose levels and weight gain.
These are large meals particularly at Iftar; indulgence in processed food and refined carbohydrates; excessive consumption of empty caloric food namely dates, juices, colas, and sugary desserts; frequent snacking and inadequate meal spacing; fast-pace eating the consequence of which is over-eating; irregular blood glucose monitoring; skipping of medications, mismatching of medications or insulin to the altered “me timings.”
“Remember to keep meal portions in moderation. Choose to eat whole grains and seeds like barley, millets, oats, semolina, quinoa, wild rice, beans and lentils,” Devjani said.
Devjani’s meal sample for people with diabetes who fast during this Holy Month of Ramadan:
Iftar: one to two small dates plus one to two glasses of water; one cup of Tabbouleh Salad; 90 to 120 grams of Chicken cooked in Curry Sauce; one cup of Steamed Wild Rice; one cup of Low Fat Greek Yoghurt; and two glasses of water.
First Snack: one Baked Apple topped with Cinnamon plus 10 to 15 Walnut Halves and two glasses of water.
Second Snack: two to three tablespoons of Hummus Dip with Carrot/Cucumber/Celery Sticks as desired plus one cup of Laban and two glasses of water.
Suhour: two slices of Whole Grain Bread, Omelette with Grilled/Sautéed Vegetables on the side, one tablespoon of Peanut Butter or 30 grams of Avocado, one cup of Low Fat Greek Yoghurt or Laban, one-half cup of Strawberries, and two glasses of water.
For Ramadan Day 2:
Iftar: one to two dates plus one to two glasses of water, one cup of Homemade Lentil Soup, one cup of Green Salad topped with Lemon Dressing, 90 to 120 grams of Lean Meat, one cup of Cooked Quinoa, one cup of Low Fat Greek Yoghurt.
First Snack: one cup of Berries topped with two to three tablespoons of Low Fat Greek Yoghurt garnished with two tablespoons of Crushed Walnuts and Pumpkin Seeds and two glasses of water.
Second Snack: two Oven-Baked Chicken Spring Roll with one tablespoon Guacamole Dip plus one cup of Homemade Pumpkin Soup and two glasses of water.
Suhour: one Small Four-Inch Brown Pita Bread, one cup of Cooked Foul, two tablespoons of Low Fat Labneh with Zaatar plus three to four Olives, one cup of Low Fat Greek Yoghurt or Laban, one Small Plum and two glasses of water.