Diabetics may have complications in fast

Rawalpindi
The diabetics falling in the third category of the disease who take insulin for controlling blood sugar should not fast because they are more likely to develop life-threatening complications and contract a number of infections while opting for fasting for over 16 hours.
Medically, fasting is not recommended among patients of diabetes falling in third category along with diabetics with higher level of sugar in their blood. In the existing extreme hot weather conditions, they are more prone to a number of complications including dehydration that may lead to acute kidney injury, said Professor of Medicine at Rawalpindi Medical College and Head of Medical Unit at Benazir Bhutto Hospital Dr. Muhammad Shoaib Shafi while talking to ‘The News’ on Sunday.
He added that greater number of patients with complications of diabetes is being reported at the BBH and allied hospitals after the advent of Ramazan of which significant number of patients was with urinary tract infections along with drowsiness and coma.
He said every diabetic cannot fast, however, most of the diabetics falling in first and second category can fast though they must check their blood sugar regularly while fasting in the holy month of Ramazan.
According to medical science, diabetics can be divided into three categories on the basis of ways and means they are advised to follow for controlling their blood sugar. Patients who control sugar level by adopting life interventions like exercise and walk fall in the first category while diabetics who use oral hypoglycaemic medicines (tablets) to control sugar level fall in the second category. The third category diabetics are those who take insulin for controlling blood sugar. Generally, the diabetics falling in the first category do not have any complications while fasting but those who are sing oral hypoglycaemic medicines must consult with their physicians before opting for fasting as they may need change in medicine or

the schedule, said Professor Shoaib while responding to a query.
He said now there are modern and latest medicines available in markets that can control blood sugar of a diabetic for 24 hours.
Talking of complications among diabetics while fasting, he said they may face palpitation (irregular heartbeat), increased sweating, restlessness and feeling of drowsiness gradually leading to coma. The chances of infections are also higher among diabetics whose blood sugar is not controlled, said Professor Shoaib.
Medical Specialist at Pakistan Institute of Medical Sciences Islamabad Dr. Wasim Ahmed Khawaja expressed to ‘The News’ that diabetics can suffer severe complications of the disease while fasting if they do not care for diet at the time of ‘Iftar’ and ‘Sehr’. “Wrong selection of diet during Ramazan and carelessness in medication can cause complications among diabetics while fasting.”
He said patients with diabetes should get themselves examined thoroughly by a qualified physician before going for fasting and should follow a diet schedule recommended by the physician. A number of chronic patients need change in schedule of medicines and diet to avoid complications while fasting in Ramazan, he said.
Diabetics in old age need more care in medication and diet as they are more prone to suffer complications like dehydration and lowering of blood pressure, said Dr. Khawaja.
He suggests that a diabetic should take moderate quantity of sweet at the time of iftar as greater quantity of sweet substances causes severe complications among diabetics. The intake of sweet substances at ‘Iftar’ may cause hyperglycaemic peaks (sudden shooting up of sugar level), which is dangerous for the patients, he said.
Talking of diet at ‘Sehr’, he said a diabetic should take plain leaf of bread (Chapati not Paratha) preferably with yogurt, milk, vegetable curry, pulses or egg and should avoid jams and marmalade. It is, however, better for diabetics to consult their physicians for proper diet chart and change in schedule of medicines during Ramazan while opting for fasting, he added. A diabetic can have all types of fruits at the time of ‘Iftar’ but in moderate quantity. Diabetics should avoid taking grapes in greater quantity. A fasting diabetic may add high protein food like fish, meat, chicken, pulses and eggs to his diet plan but after advice from the physician, he said. A diabetics must keep in mind that his immunity level is lower and he may suffer from number of infections if he does not give due attention to control sugar in blood level, concluded Dr. Khawaja.