Medical Assessment:
Before the start of fasting, diabetics patient should check with their healthcare provider at least 6 to 8 weeks before Ramadan, as this visit provides:
- Evaluating his health status to determine the possibility of fasting or not.
- Controlling blood glucose level, blood pressure and (fat percentage) blood lipids in the target range before starting fasting.
- Advising to develop a modified dietary plan that improves blood glucose level during fasting and helps those who suffer from obesity to lose weight in Ramadan.
- Developing the appropriate treatment plan by adjusting the doses and times of medicines in proportion to the periods of fasting.
Factors to measure the risk of fasting for people with diabetes depend on:
- Type of diabetes.
- Diabetes Control Medications.
- Risk of hypoglycemic episodes.
- The presence of other health problems or complications of diabetes.
- The patient's experience in the fasting of previous years.
The most common complications that a diabetic patient may experience while fasting:
- Hypoglycemia: The first risk is especially in patients with type 1 diabetes.
- Hyperglycemia: occurs when medication doses are significantly reduced, the patient becomes more likely to develop diabetic ketoacidosis.
- Dehydration: Fasting is often done in hot and humid conditions which increases the risk of dehydration, it may be due to not drinking water or some diabetic or diuretic medications, or high blood glucose levels.
- Diabetic ketoacidosis: Diabetic patients, especially those with type 1, have an increased risk of developing it, especially when not well controlled before Ramadan. The risk of developing diabetic ketoacidosis may increase due to excessively low insulin doses based on the assumption that food intake decreases during the month, so it is important that the decision about fasting is made on an individual basis in consultation with the healthcare provider.