Are there health issues if an insulin-resistant person fasts during Ramadan? What are the measures to be taken?
In general, for people with diabetes, fasting is not required during Ramadan . That being said, many people with diabetes do fast during this holy time. People with type 1 diabetes, women with diabetes who are pregnant and people taking several injections of insulin per day should not fast. If a person in one of these groups decides to fast anyway, it should only be done under the direct supervision of a physician. For others, the extent of risk during fasting depends on which medicines they are taking. People on metformin need to be careful not to get dehydrated while fasting. Drinking large amounts of fluid before sunrise and possibly changing the dosing and timing of their medication may help to prevent this. People on sulfonylureas and insulin are at greater risk of lows during the fasting hours. As with metformin, changing the dose and timing of these medications will help. Talk to your doctor about the medicines you take and adjustments that can be made to accommodate fasting. Insulin resistance in and of itself will not put you at risk. Eating a lot of calories at the end of the day, as happens during Ramadan, will cause your blood glucose levels to go high in the evening. To help avoid this, try to limit sweets and heavy carb foods at the evening meal. Make sure to have protein, fat and complex carbohydrates (such as steelcut oatmeal, whole grain breads, high fiber cereals, etc.) for your breakfast meal before dawn. This will help sustain you during your fast and keep your blood glucose levels steady. The most important thing you can do during Ramadan is make sure your doctor knows you are fasting. Also, as your doctor may not know much about Ramadan, you may need to explain, how it all works and how long it lasts so he or she will have the information needed to adjust your medicines appropriately.
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