Top diabetes expert calls for ‘vigilance’ among healthcare during Ramadan
Healthcare professionals are being urged to be “vigilant” when seeing people with diabetes who are observing Ramadan.
The religious month, which started on Monday, April 12, is marked by taking part in fasting, prayer and reflection.
Fasting during daylight hours can have physical and mental health benefits, however, for those with certain health problems, abstaining from eating, particularly the currently long (16-20 hour) fasts in Northern Europe, can lead to complications.
Dr Sarah Ali, who is a Trustee of the South Asian Health Foundation (SAHF) recently shared the SAHF evidence-based guidelines for Managing Diabetes during Ramadan during a Diabetes Professional Care (DPC) webinar entitled ‘Understanding the challenges and practical solutions for people living with diabetes during Ramadan’.
Dr Ali, also a Consultant in Diabetes and Endocrinology at Royal Free London and Clinical lead for the Barnet Diabetes Integrated service, said: “There are potential risks for people who have diabetes and choose to fast.
“The Islamic calendar is 11 days shorter than the Gregorian calendar and so Ramadan traverses the seasons with time. Ramadan is going to take place across spring and summer months for a number of years, so if you live in the UK, fasting hours are very long.
“Abstaining from food and water for long periods of time can put people with diabetes at risk of hypoglycaemia and dehydration. There’s also a risk of hyperglycemia due to the feasting aspect on opening the fast. In addition, we must be mindful of the current situation with the COVID-19 pandemic, as diabetes is recognised as an independent risk factor for severe disease from COVID-19 infection.
“We therefore stratify people with diabetes into different risk categories in accordance to their health, diabetes and medications. We recommend those who would like to fast, speak to their diabetes team as soon as possible so that they can assess the risk and advise them. With this in mind, we recognise people may still choose to fast even if they are at high or moderate risk so we need to ensure they fast safely.”
Dr Ali recommends healthcare professionals should be having conversations with their patients and explaining their options.
“Adjustments to medication may need to be made over the course of the fasting period and regular glucose monitoring is essential. So, speaking to the diabetes team in advance of fasting is important to make any changes. People with diabetes must be vigilant of when they should break their fast. If their glucose levels drop below 3.9 mmol/L or rise above 16.9 mmol/L, if they start to feel unwell or develop COVID-19 symptoms, then they must put their health first.
“COVID-19 has also added another layer of complexity to the issue as we already know that people with diabetes are at higher risk of becoming seriously ill should they become infected.
“Vaccine hesitancy is also another issue we’ve identified through our research and the message we must pass on is having the COVID-19 vaccine does not break the Ramadan fast.
“There’s an urgent need for a global call for action to reduce vaccine hesitancy to ensure we keep up the momentum. We’re urging community leaders to use Friday prayer sermons to promote the acceptance of vaccines, dispelling myths with worshippers.
“It’s vital people understand that vaccinations are the greatest tool to help the world back to normality which will eventually allow the gradual return of celebrating festivals and future Ramadans.”
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