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Ramazan - "Fasting diabetics may suffer complications"

Discussion in 'The Middle East' started by Ellen, Aug 16, 2009.

  1. Ellen

    Ellen Senior Member

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    http://www.dawn.com/wps/wcm/connect...asting-diabetics-may-suffer-complications-689

    KARACHI: 'Fasting diabetics may suffer complications'
    By Our Staff Reporter
    Sunday, 16 Aug, 2009 | 01:48 AM PST

    KARACHI, Aug 15: Diabetic patients who fast during Ramazan risk aggravating their health complications, sometimes needing hospitalisation.

    This was stated by diabetologists and medicine experts at a public awareness programme organised specially for diabetic patients by the National Institute of Diabetes and Endocrinology, on the Ojha Campus of the Dow University of Health Sciences on Saturday.

    The director of the institute, Prof M. Zaman Shaikh, told the participants that some 30 to 45 per cent of the world Muslim population with diabetes fasted during Ramazan.

    In the EPIDIAR (Epidemiology of Diabetes and Ramazan ? 1422/2001) Study which was done in 13 Islamic countries, of the 12,243 people with diabetes, 43 per cent of the patients with type-1 diabetes and 79pc of patients with type-2 diabetes kept fasts during Ramazan, he said, adding that the frequency of acute complications was higher in them.

    The duration of the daily fast may range from a few hours to more than 20 hours, depending on the geographical location and season of the year in different countries of the world. Many patients with diabetes, who are otherwise unfit, insist on fasting during Ramazan, thereby exposing themselves and their physicians to a medical challenge, said Dr Shaikh and other experts, including Prof Zeenat Ayub and Dr Iftikhar Ahmed.

    They said fasting, especially by patients with type-1 diabetes with poor glycemic control, was associated with multiple risks.

    The experts said the largest data set pertaining to diabetes patients was the recent EPIDIAR study, which showed that fasting increased the risk of severe hypoglycemia (defined as hospitalisation due to hypoglycemia), 4.7-fold increase in patients with type-1 diabetes and 7.5-fold increase in patients with type-2 diabetes.

    According to the data, a five-fold increase in the incidence of severe hyperglycemia (requiring hospitalisation) during Ramazan was confirmed in patients with type-2 diabetes and an about threefold increase in the incidence of severe hyperglycemia with or without ketoacidosis in patients with type-1 diabetes.

    Patients, especially those with type-1 diabetes, who fast during Ramazan are at an increased risk of falling unconscious due to diabetic ketoacidosis, particularly if they are grossly hyperglycemic before Ramazan. The risk for diabetic ketoacidosis may be further increased due to an excessive reduction of insulin dosages based on the assumption that food intake shrinks during the month.

    The limitation of fluid intake during fast, especially if prolonged, was also a cause of dehydration which may contribute to the volume and electrolyte depletion in hyperglycemia patient due to excessive urination.

    The speakers said it was essential that patients had the means to monitor their blood glucose levels several times daily. To remain healthy, a diabetic person must eat from all the major food groups, while the quantity of food consumed should be less than the routine days.

    They should take sufficient amount of water between Iftar and Sehr to avoid dehydration and take enough quantity of vegetables during the meal and fruits after meal and should try to avoid spicy foods and oily and fried items such as pakoras and samosas.

    All patients should understand that they must always and immediately end their fast if hypoglycemia (blood glucose of 60mg/dl) occurs, since there is no guarantee that their blood glucose will not drop further if they delay treatment. Similarly the fast should be broken if blood glucose exceeds 300mg/dl
     
    Last edited by a moderator: Aug 16, 2009

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