Prepare for a healthy Ramadan What I should know about managing my type 2 diabetes during Ramadan

Transcription

1 Prepare for a healthy Ramadan What I should know about managing my type 2 diabetes during Ramadan This booklet is part of Dialogue, a patient support programme. It has been developed and funded by AstraZeneca in conjunction with TREND-UK.

2 Ramadan The period of Ramadan is one of the holiest months in the Islamic calendar. It is when the Qur an was revealed. Ramadan lasts from sunrise (sahur) to sunset (iftar). Millions of practising Muslims around the world take part in Ramadan to receive spiritual reward from God, have their sins forgiven, and practice self-restraint. Can I fast if I have diabetes? If you have type 2 diabetes it might not be suitable for you to fast. Not fasting due to ill health follows Islamic principles. This can be discussed further with your local imam (moulvi). The holy Qur an exempts those with medical conditions from fasting, particularly if it could have harmful consequences to your health. As you have diabetes, you fall into this category. However, you may still wish to fast. If you are unsure whether you can fast or not, it is important to consult your doctor, nurse or pharmacist to discuss it further. This leaflet is not intended to be a substitute for the advice of your doctor, nurse or pharmacist. Ask your healthcare professional for further information.

3 What are the risks of fasting when I have diabetes? During the month of Ramadan, if not managed well, fasting can lead to the following problems: Hyperglycaemia This is when your blood glucose levels are too high. This can be because of poor diet or if you have changed your medication dose. Symptoms include: thirst passing more urine than normal tiredness headaches. If you experience hyperglycaemic episodes, talk to your doctor or nurse to see if you are able to continue fasting. Hypoglycaemia (or hypo) This is when your blood glucose levels are too low (below 4mmol/L). Symptoms may include: feeling shaky sweating feeling hungry tiredness going pale blurred vision not being able to concentrate headaches feeling emotional feeling moody or angry. This may happen if you are using insulin or certain diabetes tablets (Check with your diabetes nurse or pharmacist to see if you are at risk). Talk to your doctor or nurse about how frequently you should monitor your blood glucose levels during Ramadan and what to do if you experience a hypo. If left untreated, hypoglycaemia can be dangerous. Treat immediately with one of the following: 5-6 dextrose tablets 100 ml Lucozade 150 ml (half a can) of non-diet fizzy drink 200mL (small carton) of fruit juice 4 large jelly babies. Test your blood glucose after 10 minutes. If still less than 4 mmol/l, or you still have symptoms, repeat the treatment. Follow with a starchy snack like fruit or biscuits.

4 Recommendations for people with diabetes who fast: Pre-Ramadan assessment It s important to see your GP or nurse at least 4 weeks before Ramadan, to discuss your options. Remember, your health status can change from year to year so it s important to discuss each year whether you should fast or not. Dehydration Fasting for long periods, especially in hot and humid climates, can lead to dehydration. Drink plenty of fluids before the fast begins at sunrise (sahur) and at the end of the fast at sunset (iftar). Medicines Your diabetes medicines might need to be adjusted during the month of Ramadan depending on what medication you are taking, the length of the fast, and how well controlled your diabetes is. You should see your doctor or nurse to discuss this, ideally at your pre-ramadan assessment. Food Sugary foods and drinks will cause high blood glucose levels. Fried and high-fat foods will cause weight gain. Therefore, try to keep to sensible portions of these foods when breaking your fast.

5 Points to remember for people with diabetes who fast during Ramadan: Activity During the fasting period, continue with light to moderate activity, but always consult with your doctor should you wish to increase your activity levels for any reason. Taraweeh (night prayer) can be included as part of your activity programme. Smoking As smoking is not permitted during Ramadan it s a good time for you to think about quitting. Speak to your doctor or nurse about this. Many pharmacies offer free smoking cessation services that can help you. Blood glucose monitoring Talk to your doctor or nurse about how frequently you should monitor your blood glucose levels during Ramadan. If you feel unwell or have had your medication adjusted during Ramadan then you should check your blood glucose levels. Checking them is not considered to be breaking your fast. If you have doubts about this, you can discuss them with your imam. Changes to my diabetes medication during Ramadan: Medication Dose Frequency Remember to discuss your medication with your doctor or nurse before fasting. If you have to break your fast for any reason, continue your meals as normal for that day. If you re able to, you could make up the fast at a later date or provide fidyah (paying for someone poor to be fed). You should ask your imam about this.

6 Fasting and diabetes As you know, Sharia law permits the sick to be excused from fasting during Ramadan and offer fidyah instead. Understandably, despite this provision some Muslims with type 2 diabetes still wish to fast. They should discuss the decision with their doctor or nurse to ensure they don t damage their health and to agree a medication schedule that works best for them during Ramadan. Because fasting makes blood glucose levels fall, this may lead to an episode of hypoglycaemia (low blood glucose, also known as hypo ). The earlier hypos are treated, the easier it is to correct them. If members of your congregation with type 2 diabetes do decide to fast, it is very important that they discuss their medication schedule with their doctor or nurse and then take their medication as agreed throughout Ramadan. If you would like more information on type 2 diabetes, please visit , Date of preparation: April 2014

7 For your imam To help your imam understand more about your condition and how it is affected by Ramadan, tear off this sheet and give it to them to read. What is type 2 diabetes? Diabetes is a lifelong condition where the level of glucose in the blood is too high. Around 2.5 million people in the UK have type 2 diabetes, with South Asian and black people at the most risk of developing it. Tear off here In people with type 2 diabetes, either a large gland in the digestive system, called the pancreas, doesn t produce enough insulin, or the person s body doesn t respond to the insulin in the right way. This can make their glucose level too high. The possible long-term effects of type 2 diabetes include heart disease, stroke, kidney failure, nerve damage, blindness and amputation.

8 123, Date of preparation: April 2014