PUNE: Despite serious health risks that fasting could pose to diabetics, research shows that more than 79% of world's Muslims or 50 million people with diabetes worldwide, continue to fast during Ramadan against the advice of healthcare professionals, said diabetologist Abhay Mutha of Ruby Hall Clinic here on Thursday.

Ramadan is one of the five pillars of Islam and takes place in the ninth lunar month of the Islamic calendar (linked to the sighting of the new moon). This year Ramadan is observed between July 20 and August 18.

During Ramadan, people with type 2 diabetes who fast abstain from eating, drinking, and using oral medications from pre-dawn to after sunset. Most people consume two meals per day during this month, one after sunset and the other before dawn.

"Research shows that the changes in eating patterns experienced during fasting can put people with type 2 diabetes at risk of complications including low blood sugar ( hypoglycemia), high blood sugar (hyperglycemia), diabetic ketoacidosis, thrombosis and dehydration," Mutha said.

If left untreated, low blood sugar (hypoglycemia) can lead to serious medical problems including loss of consciousness, convulsions or seizures, which require emergency treatment. Therefore the American Diabetes Association (ADA) recommendations for management of diabetes during Ramadan state that all people with diabetes who wish to fast seek medical advice before Ramadan, Mutha said.

Preparing for Ramadan
The ADA recommendations for management of diabetes during Ramadan

• It is important that people with type 2 diabetes wishing to fast during Ramadan undergo a pre–Ramadan medical assessment one to two months before Ramadan.
• Blood sugar levels should be monitored more frequently during Ramadan, to reduce the risk of developing low blood sugar (hypoglycemia).
• Tailored management of diabetes during Ramadan, including treatment changes, can help to minimise the risks associated with fasting.
• People with diabetes also need to receive appropriate education and advice to ensure they understand the risks associated with fasting and enable them to recognise the symptoms of low blood sugar (hypoglycemia).