Majority of diabetes patients prefer fasting in Ramadan despite having the condition.

"A majority of our patients prefer to fast during Ramadan despite having diabetes. While they are aware that they are exempt from fasting as it can have an adverse effect on their health, they are keen to follow all the rituals of Ramadan," said Abdulla Mohamed Juma, director of administrative affairs at the Dubai Diabetes Centre of Dubai Health Authority (DHA).

The centre meets patients individually prior to Ramadan to check if the patient is medically capable of fasting as well as to adjust their medication and provide an individualised diet plan.

Dr M. Hamed Farooqi, director of the centre, said: "While everyone needs to follow certain precautions while fasting, diabetics have to take extra precautions because their body does not have the ability to control fluctuations in blood sugar level. They also dehydrate faster especially when their sugar levels rise, therefore they need to ensure they take sufficient precautions to maintain their sugar levels while fasting.

"The most important step for any diabetic who chooses to fast is to ensure he visits his health practitioner so that the doctor can advise whether it is safe for him to fast and to gauge whether his body will be able to manage long hours of fasting. Once that is ascertained, the patient needs to modify the medication dosage - usually lower the dosage - to ensure they maintain their sugar levels."

Dr Farooqi said that both, an increase or drop in the sugar level for diabetics with Type 1 and 2 diabetes can cause serious complications, like loss of consciousness, so diabetics have to be extremely careful when fasting.

"A drop in the sugar level can cause several other symptoms such as weakness, shaking of the hands, difficulty in speech, heart palpitations etc. This situation occurs due to low sugar and excess insulin in the body. This can happen in both type and type 2 diabetes," he added.

"It is important for diabetics to carry a sugar source with them at all times and if they experience these symptoms, they should immediately take the sugar source and contact their doctor or emergency services depending on the urgency of the situation."

On the other hand, a condition called diabetic ketoacidosis can occur in people with type 1 diabetes when there is no insulin in the body. This happens if the long acting insulin dose is missed and can also cause the patient to fall into a coma. Inaam Ibrahim Kandil, head of diabetes education coordination, said: "The problem we face is that many diabetics do not realise the complications they can suffer from while fasting if they neglect taking certain precautions while fasting. Therefore awareness is the key to ensure our patients do not face any health consequences due to fasting and keeping their blood sugar within target range as it was before they began their fasts and not indulge in eating the wrong foods."

Manal Al Buflasa, senior nurse educator, said that while diabetics are keen to adhere to the rituals of Ramadan, it is permitted to break the fast when a diabetic goes through any complications while fasting during the day.

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