Dubai: Residents with type 2 diabetes who are fasting should educate themselves on meal planning, physical activity, glucose monitoring, and dosage and timing of medications, said specialists in diabetes.

They believe that education is vital to avoid and manage complications. According to medical opinion, the risk associated with fasting is low among patients with type 2 diabetes, especially those with good blood sugar control. A common risk is however postprandial hyperglycaemia (high blood sugar) after the predawn and sunset meals. Hyperglycaemia can be prevented if patients distribute calories over two to three smaller meals during the non-fasting period.

Speaking exclusively to Gulf News, Dr Prakash Pania, Specialist Endocrinologist at the Aster Jubilee Medical Complex, Dubai, highlighted the importance of prior consultation. “A Type 2 diabetes patient should consult a doctor prior to fasting to access the risks and formulate a plan to fast safely. In older people, who have been diagnosed with diabetes for several years, this consultation is even more important because they often require insulin, which has to be adjusted [in dosage] for the fasting phase,” he said.

All patients are encouraged to fast but those who have complications, poor control of blood sugar for the past three months, experienced weekly episodes of low sugar level (hypoglycaemia) or those who have complications from diabetes such as kidney disease are advised against fasting, said Dr Pania.

He cautioned against the culture of ‘feasting after fasting’. 
“After 15 hours of fasting, the digestion shouldn’t be burdened or it could lead to a spike in the sugar level and/or lead to digestive disorders like acidity and reflux,” he said.

According to Wadad Aboul Khoudoud, programme director of the Decide Diabetes Support Programme, an online not-for-profit programme with information about diabetes, in collaboration with Dubai Health Authority (DHA), checking one’s blood sugar level while fasting is a must.

Wadad said: “Diabetic patients should make sure their condition is well controlled on diet and/or medication. They should check their blood glucose level before iftar [evening meal] and suhour [morning meal] and three hours after iftar or as recommended by the doctor. They should have a balanced diet recommended by their nutritionist or doctor.”

She advised type 2 diabetic patients to have iftar on time and to delay suhour as much as possible and to keep the body hydrated by drinking enough fluids.

“If symptoms of low sugar level [hypoglycaemia] appear eg, dizziness, tiredness, difficulty concentrating, sweating, rapid heartbeat, or blood sugar is 70 mg/dL [milligrams per decilitre] or less, a diabetic patient should break his/her fast immediately,” she said.