KARACHI - Assistant Dean Clinical Sciences in United Medical and Dental College Karachi, Prof Dr Farhat Bashir said that about 50 million people with diabetes fast during Ramadan worldwide and recent advancements give us opportunity to offer the patients a normal or near-normal life. 

Diabetes Mellitus is a chronic disease. People, fasting with diabetes, are required to have a balanced diet with plenty of fruit, vegetables, and salads, and minimise foods that are high in saturated fats. Prof Dr Farhat Bashir expressed these views while speaking at the online public awareness seminar on “Management of Diabetes in Ramazan” held at the Dr Panjwani Centre for Molecular Medicine and Drug Research (PCMD), University of Karachi on Wednesday. Prof Farhat said that the prevalence of type 2 diabetes and prediabetes were much higher in Pakistan. 

She pointed out that management of diabetes was quite important for diabetic patients who wish to fast. The major risks of fasting are mainly hypoglycaemia (low blood sugar) and hyperglycaemia (high blood sugar), she said, adding that pre-Ramazan assessment and structured education including diet advice, self-glucose monitoring, selection of appropriate medication to avoid hypoglycaemia, are quite important for the patient to be healthy in the holy month.

She advised the diabetic patients, who are suffering from other fatal diseases like renal and cardiac diseases, not to observe fast due to high risk. She asked the diabetic patients, who wish to fast, to visit a doctor one or two months before Ramazan, while after Ramazan they need to visit their physicians for review and adjustment of diet, exercise, and medication.

Talking about exercise in Ramazan, she said diabetic patients were required to reduce physical activity during the daytime. However, physical exercise can be performed about one hour after Iftar, she said, adding that increase in postprandial physical activity during the night associated with Tarawih.

She advised the diabetic patients to use balanced diets that included low glycaemic index, high-fiber foods that release energy slowly before and after fasting. The healthy diet for diabetic patients also includes plenty of fruit, vegetables, salads, granary bread, beans, rice, fruit, vegetables, and salads, the lady professor said, adding that diabetic patients must avoid sugary desserts and other foods that are high in saturated fats, like ghee, samosas, and pakoras. The patients need to use drinking water or other non-sweetened beverages after Iftar and before Sahar, she said, saying that they are required to avoid caffeinated and sweetened drinks.

 Prof Bashir also advised diabetic patients not to avoid monitoring blood sugar level, and adding that they must check their blood glucose levels whenever they experience symptoms of hypoglycaemia, hyperglycaemia,or feel unwell, and understand when they should immediately break the fast. Individuals who are on insulin need to monitor their glucose more frequently, and this is also mandatory for them to measure blood glucose after Iftar to detect postprandial hyperglycemia, he observed.