Transcript Diabetes in the holy month of Ramadan

Diabetes
in the
Holy Month of Ramadan
Dr. M.K. Abedi
Why are we here today?
 Islam
is the second largest religion in the
London Borough of Enfield.
 Diabetes is most common amongst Asian
patients.
 This year Ramadan is expected to begin on 28th
June 2014 at the sighting of the new moon
 Ramadan
will end on 28th July 2014
Diabetes and Ramadan
Diabetes is a condition in which the amount of
glucose (sugar) in the blood is too high because
the body cannot use what we eat properly.
 During the Holy Month of Ramadan people change
their eating habits. This may affect blood glucose
levels in a way that can make some people feel
very unwell.
 We are here to give you information on how to stay
well.
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Fasting in 2014
This year you will be fasting for up to 19 hours
 July may also be very hot
 Peak temperature in London is 300 C ( 900 F)
 Average temperature in London is 220 C (700 F)
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If you have diabetes
You need to make an appointment to see your
General Practitioner or Practice Nurse
 What needs to be considered:
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What treatment are you on?
 Has your health been generally good in the last year?
 Are your blood glucose levels generally well controlled?
 Do you have diabetes complications?
 How have you managed during Ramadan before and
how have you felt?
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If you have diabetes who should not
fast?
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If you have recently been diagnosed
If you have Type 1 or Type 2 diabetes that is not well
controlled
If you have hypo unawareness
If you are elderly or frail
If you have a history of diabetic ketoacidosis
If you have been having recurrent infections
If you have kidney problems
If you have had problems fasting before
If you have unstable epilepsy
What are the risks of fasting for
Ramadan if you have diabetes?
 Hypoglycaemia
 Low
blood glucose levels
 Hyperglycaemia
 High
blood glucose levels
 Dehydration
 Lack
of fluid in the body
Symptoms of Hypoglycaemia or
Low blood sugar
These vary from person to
person
Fast heart rate
 Sweating
 Weakness
 Feeling jittery
 Irritability
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Confusion
 Dizziness
 Drowsiness
 Headache
 Hunger
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Causes of hypoglycaemia
If you take insulin, you may have taken too much
 Lumpy injection sites
 You may have reduced the amount of
carbohydrate in your diet
 You may have delayed or missed a meal
 Increased stress levels
 Increased your physical activity
 Hot weather can affect some people
 Some drugs can cause hypoglycaemia
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Treatment for hypoglycaemia
Check blood glucose level if possible
 Eat or drink something sweet
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Lucozade 50 – 100 mls
 Or Coke 50 – 100 mls (NOT DIET COKE)
 Or 3 – 6 glucose tablets
 Repeat if symptoms are not resolved after 5 – 10 minutes
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When feeling less unwell, eat your next meal or
have a snack like a sandwich or a banana
 If you are getting episodes of hypoglycaemia you
will need to visit your GP
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Symptoms of hyperglycaemia or
high blood sugar
 Weight
loss
 Increased thirst and dry mouth
 Tiredness
 Blurred vision
 Headache
 Loss of concentration
 Frequent urination
Causes of hyperglycaemia
You have stopped your medication
 You are taking the wrong dosage of your
medication
 You have reduced the amount of activity that you
do
 You have changed your diet
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Treatment for hyperglycaemia
Take correct dosage of medication at the correct
time
 Take regular physical exercise
 Avoid changes to healthy eating plan
 See your GP if symptoms persist
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General precautions for Ramadan
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Plan your meals carefully
Do not skip meals
Avoid over eating at Iftar or Sehri
Continue to take your medicines as prescribed by your
doctor
If Type 1 diabetes check for ketones if blood glucose
level is high (>14 mmols)
Drink plenty of sugar free drinks
Know who to contact if in an emergency
Your Diet
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If breaking fast with dates and milk, if diabetes is present
dates should be limited to a maximum of 3
Limit or avoid sweets and fried foods at the start and
break of your fast
Try to fit in 5 portions of fruit and vegetables a day
Fill up on starchy foods like rice, chappati, couscous,
wholegrain bread
Eat foods higher in fibre as these are more filling and
can prevent constipation
Drink lots of fluids before fasting commences
Medication
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There are leaflets available today that will give
you further guidance about your medications for
diabetes and how fasting may affect how they
work
If you are concerned about your tablets, contact
your GP or Practice Nurse.
Other possible health problems during
Ramadan
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Headache:
 Try
to eat foods that have a slower absorption rate
e.g. grains and pulses.
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Constipation:
 Drink
plenty of fluids and eat foods that are high in
fiber.
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Indigestion:
 Reduce
fried foods and eat smaller portions at a time.
We wish you all a
healthy Ramadan