KARACHI: Experts at an international conference on diabetes and Ramazan on Sunday said that people with diabetes must acquire pre-Ramazan education and consult their physicians for safe fasting in the approaching holy month.

They said there were around 150 million Muslims living with diabetes across the world and about 35 millions of them lived in Pakistan, of whom 90 per cent could fast in Ramazan provided they got prior education vis-à-vis their dietary plans, dose management of medicines and insulin; when and how to check their blood glucose levels and what should be done in case of low and high blood sugar levels while fasting.

“People need to understand that fast is not broken by undergoing lab test or checking blood sugar by pricking, having insulin or glucose injections even if they provide energy, getting medicines in the eyes and ears; while those who break the fast on the advice of doctors would not have to offer Kaffara as they would only be required to keep fast when they feel themselves healthy and fit again,” these observations were documented by national and international experts and consultant diabetologists at the 5th International Diabetes and Ramazan Conference, organised jointly by Baqai Institute of Diabetology and Endocrinology (BIDE), Karachi and Ramazan Study Group in collaboration with Diabetes and Ramazan (DAR) International Alliance at the College of Physicians and Surgeons Pakistan.

Eminent diabetologists, including Dr Mohamed Hassanain, chair DAR International Alliance from United Arab Emirates, Prof Mehmet Akif Buyukbese from Turkey, Prof Abdus Sammad Shera, honorary president of International Diabetes Federation (IDF), Prof Abdul Basit, director of BIDE and president of IDF Middle East and North Africa (MENA) Region, Prof Khalid Masood Gondal, vice chancellor, King Edward Medical University Lahore and Dr Yakoob Ahmedani, chairman of Ramadan Study Group spoke over safe fasting during Ramazan.

Prof Buyukbese said fasting helped in weight loss from 3pc to 8pc which helped in hypertension management, and prevented from various cancers.

He, however, advised diabetics to consult their physicians well before advent of Ramazan to fast safely.

Dr Hassanein, an Egyptian diabetologist trained in UK, said for people with diabetes, their doctors should be their imams and if their physician told them not to fast during Ramazan as it would harm their health, they should listen to the experts instead of their religious leaders.

“A vast majority of Muslims with diabetes can keep fast if they get pre-Ramazan education which should be focused on when a person can break fast, medication adjustment, blood glucose monitoring during fasting, fluids and dietary as well as exercise advice,” he said.

Prof Basit said majority of people with diabetes in Pakistan kept fast irrespective of their health condition and it was the responsibility of their doctors to educate them well before the start of Ramazan on safe fasting practices, medication adjustment, blood sugar monitoring during fast, diet plans and exercise.

“Except for people with very high risk, including those who have chronic heart or kidney diseases, have to take oral medicines three to four times a day and those who have been advised to refrain from keeping fast, all other patients with diabetes can keep fast in consultation with their physician and experts,” Prof Basit said, adding diabetics could check their blood sugar level by pricking as it would not break their fast.

“If the blood glucose level of a diabetes patient drops below 70 mg/dl while if the blood glucose level rises above 300 mg/dl with symptoms of hyperglycemia, such patients are also advised to break their fast,” he added. “Such patients would not need to have offer Kaffara, and they would only have to keep ‘Qaza Roza’.

Prof Ahmedani said pre-Ramazan education for diabetic patients was a must and such patients should start preparing and consulting their physicians in time so that their doses could be adjusted.

Published in Dawn, March 25th, 2019