How do diabetics spend the month of Ramadan?

The poet Mashreq had said that the series continues to test a person day and night. It is the saffron that separates the dross from the dross.

Time is another name for a continuous flow. In which day and night have no status. The real truth of Almanac is that it analyzes the self and the universe. From this analysis, a universal truth emerges that the end of all existence is annihilation.

The first and the last are internal and external annihilation

Naqsh-i-Khan that the nine stages of the end of destruction

Every existence in this world will surely perish, but eventually the day will come when every human being will be reborn. He will appear before the creator of the universe and a new life will begin. Our performance in this mortal life will determine our place and status in the eternal life. There is a month in our intentional calendar in which we are trained and prepared to appear before the Lord of the Worlds.

“On that day when all people will stand before the Lord of the Worlds” (Al-Mutaffin)

Blessed are those souls who have been blessed with the most important and most blessed month of the Islamic calendar. Ramadan is the month in which the last word of Allah was revealed. In which the best night i.e. Lailatul Qadr is found for a thousand months. This is the night that gives us a sense of the calendar of love, where today’s scales are rendered meaningless. Fasting on all the days of this month is obligatory on every Muslim, but the Most Merciful Malik made an exception for those who are unable to fast for any reason.

“And whoever is sick or on a journey, he should complete the number of fasts on other days” (Al-Baqarah 185).

Travel and illness are usually temporary. But there are some diseases that continue with a person throughout his life. Diabetes is also such a disease, but by adopting good planning and strategies, one can lead a normal life with diabetes or diabetes and fasting can also be done in the light of the doctor’s instructions.

Before discussing how diabetics should spend the month of Ramadan, we should know what diabetes is and what problems a person faces due to it.

Diabetes is a chronic disease in which the amount of sugar or glucose in the blood increases. Over time, diabetes can seriously damage other parts of the body, including the heart, blood vessels, eyes, kidneys, and nerves.

Glucose is essential for our survival. It makes our body grow. We get the energy we need and the journey of life goes on. In diabetes, a person may have many complaints and symptoms, for example (excessive urination) especially at night, extreme thirst, weight loss, vision problems, excessive appetite, severe fatigue, non-healing of wounds. , dry skin, numbness or tingling in the hands and feet, frequent bacterial attacks and decreased immunity.

Diabetes has now become a global problem and the number of its patients is constantly increasing. The target of this disease is all the countries of the world. There is no distinction between rich and poor in this regard. Currently, there are around 550 million people with diabetes in the world. 20 years from now, this number will increase to 780 million.

China has the highest number of diabetes patients. Their number is around 140 million. In India this number is around 74.2 million. Pakistan is on the third position in this list. More than 33 million people in Pakistan are suffering from diabetes. Overall, 31% of Pakistan’s population is suffering from diabetes. In terms of ratio, Pakistan ranks first in the world where every third person is a diabetic.

There are generally two types of diabetes. Type 1 diabetes and type 2 diabetes. We should know the difference between these two types because on this basis it is decided whether a diabetic patient should fast or not.

In type 2 diabetes, the pancreas stops making insulin or makes very little insulin. Insulin is the name of a hormone that is produced in specific cells of the pancreas (Beta Cells). The amount of glucose in food is controlled by insulin. Under the influence of insulin, glucose enters the various cells of the body and provides energy.

In type 2 diabetes, the pancreas makes insulin, but in small amounts. On the other hand, immunity develops in the cells of the human body and the effects of insulin on them are lost. As a result, the amount of glucose in the blood keeps increasing. Type 1 diabetes is treated with insulin only, and insulin is delivered subcutaneously by injection or pump.

Type 2 diabetes is treated with oral medications while paying close attention to exercise and diet. In some cases, patients with type 2 diabetes are given insulin by injection along with other medications.

Doctors do not allow type 1 diabetes patients to fast. These patients are given multiple injections of insulin, usually before meals. If these patients do not eat anything after the injection, they may suffer from severe swelling and weakness. These patients should not fast and should pay fidya.

Patients with type 2 diabetes can fast on doctor’s advice, but dosage and timing of medication may need to be changed. Only diabetic patients should fast if their disease is under control and their blood glucose levels are not unbalanced. It is also necessary to see that there has not been a severe drop in blood glucose during the last three months.

Sudden hypoglycemia is very important and patients should be aware of its symptoms. These symptoms are (1) Abnormal appetite and weakness (2) Intense hunger and craving for sweets (3) Increased heart rate (4) Cold hands and feet (5) Cold sweat (6) Mental Change in status (7) Being nervous. Patients with these symptoms should break their fast and eat something sweet immediately and consult the nearest doctor.

Fasting diabetics should monitor their blood glucose levels. If the glucose level is less than 70mg/100ml, the fast should be broken.

If the glucose level is between 70 and 90 mg, retest within one hour. If the amount of glucose in the blood exceeds 300 mg, the fast should be broken. Our body’s system is in such a way that after eight hours of Suhoor, the stored energy starts to be used to keep the amount of glucose within limits, which can result in a lack or excess of glucose. Likewise, there can be severe shortage of water, especially during the summer months.

It is important for diabetic patients to consume more water at the time of Suhr and Iftar, but avoid sweet drinks. If attending the Taraweeh prayer, drink adequate amounts of water before, during, and at the end of the prayer.

Diabetic patients have to take care of their diet throughout the year, but special attention is needed during fasting. Eating excess or unhealthy foods can lead to weight gain and imbalanced blood glucose levels. They should consume carbohydrates or starches that are high in fiber, such as wholemeal bread and dark-colored double-grain bread, which also has healthy porridge.

Pulses, legumes, vegetables and fruits should also be consumed more. Fish, chicken and eggs should be eaten for meat or protein. At the time of breaking fast, one should avoid too sweet and fatty foods including pakoras, samosas, kachoris and sweets. We all wish to break our fast with dates, but we should not forget that dates are very sweet, so we should be satisfied with two or three dates.

We would like to list here some important guidelines for diabetic patients which should be kept in mind in this holy month.

• Keep checking your fasting blood glucose levels, especially at these times: before sunrise, two hours after sunrise, at noon, before sunset, and at night before going to bed.
• People with type 1 diabetes should not fast. Patients who strongly desire to fast should consult a specialist doctor. If their insulin timing can be adjusted so that fasting blood glucose levels are not imbalanced, then they can fast. The first priority is that they should not fast and pay the ransom.
• A sugar cube or other sweet item should be kept with you for immediate use when needed.
• Adequate rest is also important in the holy month. Lack of sleep at night can lead to unbalanced blood glucose levels.
• If there is a severe lack of water in the body or dehydration, then the fast should be broken.
• Many people with type 2 diabetes use insulin. They should consult their doctor to readjust the amount and timing of insulin.
• Diabetic patients who perform vigorous physical activity should not fast.
• A diabetic patient should avoid fasting if she is pregnant.
• Many diabetics suffer from other physical disorders such as heart, blood vessel and kidney diseases. Fasting will not be appropriate for such patients.

We pray to Allah Almighty to grant us all the blessings and blessings of Ramadan. May those attributes of Mu’taqin be born in us which will remain intact throughout the year. (Amen)

(Dr. Iftikhar Barni, Public Health Specialist and General Secretary of Pakistan Islamic Medical Association (PIMA). Practices in Islamabad.)