CAIRO - With the countdown begun to the Muslim Holy Month of Ramadan, which will start around the beginning of August, the five million Egyptian families who have at least one diabetic member need to begin their preparations for the fast. On a scientific basis, diabetics tend to be precluded from fasting in Ramadan in order to avoid complications of their condition, especially given that the Holy Month this year will experience high temperatures and the number of daily fasting hours will reach 16. Therefore, Muslims suffering from diabetes should consult their doctors before Ramadan starts to check up on their health and for their doctors' recommendation whether it is possible to fast or not. Their doctors should also define the appropriate regimen and diet of the fasting patients. The facts concerning the fasting of diabetic people during Ramadan were the topic of a conference recently held in Cairo. According to Dr Sherif Hafez, professor of abdominal diseases in Cairo University's School of Medicine, there are a number of risks, which patients with type II diabetes may be exposed to if they would fast without consulting their doctors. These hazards are represented by the lowering of the blood glucose level. Professor Hafez explained: “Upon fasting for a long time, that is more than six hours, the body can exhaust the glucose in the body and then needs to the store inside the liver. Thus, if there were any problems in liver functions that would prevent the liver from discharging the needed glucose and lead to a low sugar level in blood, that consequently will lead to severe complications.” He added that any diabetic patient suffering from a low blood sugar level is not allowed to fast, according to recommendations of American Diabetes Association. Dr Salah Shelbaya, professor of abdominal and diabetic conditions, noted that type I diabetics patient, who are usually children and adolescents are not allowed to fast during the Holy Month of Ramadan, because they are taking insulin. He added that the diabetic pregnant woman also should not fast, because she has to take two or three daily doses of insulin. Accordingly, fasting represents a risk to both herself and her baby. Dr Shelbaya warned that diabetic patients, who fast for 16 hours without consulting their doctors, expose themselves to increased coagulation, even coma. This especially applies if they are already suffering from blood clotting, which puts them at risk of strokes, particularly if they are not taking in the requisite quantities of fluids and are taking certain kinds of tablets. If there is a risk of a coma occurring, diabetic patients should break their fasting immediately, Dr Hafez stated, noting that their caregivers should provide them with sweetened drinking water or candies and avoid chocolate because it contains fats. Blood analysis should then be made and medical advice sought. In reiterating his advice that type II diabetics should consult their doctor before Ramadan, he noted that if they are allowed to fast, their doctors can change the treatment into long-acting oral drugs that are taken once daily. However, health contra-indications for fasting apply to those needing to have an insulin dose every six hours, which should be followed by a nutritious meal.
