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Fasting with Diabetes

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Planning ahead is always good and when you plan to fast with diabetes, it is essential. Your blood glucose level changes throughout the day, affected by food, exercise and medication, but mostly by food. The makers of the OneTouch® brand are here to help.

Check with your diabetes team several months before fasting and follow their recommendations to help you manage your diabetes. Self-monitoring of blood glucose can motivate people with diabetes to become active participants in their own care. Every OneTouch® meter is designed to make it easy to test your blood glucose and help you manage your diabetes.

Here are answers to some frequently asked questions by people with diabetes

Can I draw blood and test my blood glucose during my fast?
YES, testing your blood glucose levels regularly, according to your healthcare professional’s recommendations is important. This will help you to manage your blood glucose level and recognize when your blood sugar levels are high or low.1

Testing your blood glucose while fasting does not break your fast

May I eat dates while I am breaking my fast?
YES, consumption of 100 g of dates provides 50–100% of the recommended dietary fiber Intake. Dates are high in fructose which is a more powerful sweetener than glucose and it is less rapidly absorbed than sugar, which results in a relatively low glycemic index.1

Can I pray Taraweeh or will this make me at a risk of low blood sugar?
YES, Taraweeh prayers should be considered as a part of the daily exercise program but, you should monitor your blood glucose period.
Choose to eat starchy foods with Iftar, which are digested slowly, and to drink plenty of water before prayers period.1

Make sure that you carry sweets or glucose tablets with you at all times.2

Do I need to wake up for Suhoor?
YES, you must eat a meal at Suhoor just before sunrise and not at midnight as this will help to keep your blood sugar levels more balanced through fasting.2

You are always advised to follow your healthcare professional’s advice. Here is some additional guidance to help you with monitoring your blood glucose during fasting period

  • At the beginning of the fast and then regularly every 4 h throughout the day.

  • Test immediately if you feel any symptoms of low/high blood sugar level or you become unwell.

  • 2–4 times daily before, during, and after the fasting period, if you are receiving insulin or insulin secretagogues.

  • Once or twice daily if you are treated with diet or with antidiabetic agents associated with a low risk of hypoglycemia.

Testing your blood glucose level multiple times daily, helps you early detect your highs and lows and minimize complications. OneTouch® blood glucose meters with ColourSureTM technology make testing easy and help you understand what your numbers mean.

Fasting can put patients with diabetes at risk of dehydration. Here are some tips to help you stay hydrated during your fast

  • Drink a lot of water at Suhoor and Iftar, and during the hours in between.

  • Fruit juice is best avoided but if you choose to have juice, just drink a small glass(120ml).

  • Avoid soft and fizzy drinks as they are high in sugar. It is best to even avoid the diet varieties as they contain caffeine.

  • Avoid drinking tea or coffee, these contain caffeine and can make you dehydrated.

When it’s time to break your fast, consider these tips:

• Iftar should begin with plenty of water to overcome dehydration from fasting, and 1–2 dried or fresh dates to raise blood glucose levels

Your Iftar meal should be a healthy, well balanced meal that may consist of:

  • 1 cup of vegetables

  • 1.5 cup of whole grain rice

  • Half cup of proteins (fish, skinless poultry)

  • A piece of fruit

  • Half cup of lentils, beans

  • A cup of low fat milk or yoghurt (dairy product)

• Fat as olive oil or oily fat from tuna and sardines and salmon are recommended. (2 teaspoons only)
• When breaking the fast you are hungry and so tend to eat fast, which can lead to overeating as it takes time for your stomach to signal to your brain that it is full. Try to enjoy your meal slowly and stop as soon as you feel full.
• Take Suhoor as late as possible, especially when fasting for >10 hours to avoid low blood sugar during your fast.
• At Suhoor, it is advised to eat more dairy products or vegetables or beans than carbohydrate rich food like rice or bread or potatoes so it doesn’t affect the blood glucose level after meal.

To help avoid high blood sugar level after your Iftar, try to avoid the following

  • Sugar-heavy desserts should be avoided after iftar and between meals. A moderate amount of healthy dessert is permitted, for example a piece fruit

  • Carbohydrates like wheat flour and starches like corn, white rice and potato.

  • Protein that are high in fats (e.g. beef, lamb, hot dog, salami)

  • Ghee, butter, margarines

  • Having large and frequent snacks between the two main meals

  • Frying, it is advised to bake or grill food

Check your blood glucose level during the day and post -meal to reduce the risk of high blood level that may occur after meals.4

Maintaining a regular light exercise can help you manage your blood glucose levels

Normal levels of physical activity may be maintained. However, excessive physical activity may lead to higher risk of hypoglycemia and should be avoided, particularly during the few hours before the sunset meal.3

Remember

Taraweeh prayers, such as bowing, kneeling and rising, should be considered part of your daily exercise activities.4

  • Drink plenty of water before Taraweeh prayers to avoid dehydration during prayers.1
  • If you are having low blood sugar level after Taraweeh, you may need to adjust your diabetes treatment, you must see your diabetes healthcare professional or nurse for advice.2
Testing your blood sugar with OneTouch® meters after Iftar can help you manage your diabetes.

When your fast is over, it is time to safely get back to your regular daily routine

Eid is a time of celebration and feasting. While we all deserve to enjoy this time, be aware of the risk of overindulgence that Eid presents

• Many celebratory foods can be high in fat and sugar. Be sensible and you can participate but try to moderate the amounts you eat like cookies, biscuits and Kahk.2
• A post-month of fasting follow-up meeting with your healthcare professional is advisable in order to assess how you handled your fasting, also to readjust your therapeutic regimen that may be changed back to its previous schedule, if your glycaemic control was satisfactory before month of fasting.4

OneTouch® is the only brand of meter to offer ColourSure™ technology, that instantly shows when your blood glucose numbers are in range or not.

Learn more about OneTouch® blood glucose meters

Learn more

Patients are advised to talk to their healthcare professional about the low and high range limits that are right for them. The low and high range limits you set in the OneTouch Verio® and OneTouch Select Plus Flex® meters apply to all glucose test results. This includes tests taken before or after mealtimes, medications and around any other activities that may affect blood glucose.

References
1. Ibrahim M, Abu Al Magd M, Annabi FA, et al. Recommendations for management of diabetes during Ramadan: update 2015. BMJ Open Diabetes Research and Care 2015;3: 1-10.
2. The Muslim Council of Britain. MCB. Ramadan and Diabetes: A guide for patients. June 2013. Available at: http://www.mcb.org.uk/wp-content/uploads/2014/06/Ramadan-and-diabetes-A-guide-for-patients-2013.pdf. Last accessed on: 16/05/2018.
3. Ahmad J, Pathan MF, Jaleel MA, et al. Diabetic emergencies including hypoglycemia during Ramadan. Indian Journal of Endocrinology and Metabolism. 2012;16(4):512-515.doi:10.4103/2230-8210.97996.
4. International Diabetes Federation, IDF. Diabetes and Ramadan International Alliance, DAR. Diabetes and Ramadan: Practical Guidelines. April 2016. Available at: http://www.daralliance.org/daralliance/wp-content/uploads/IDF-DAR-Practical-Guidelines_15-April-2016_low.pdf. Last accessed on: 16/05/2018.
5. Ali S, Davies MJ, Brady EM, et al. Review Article Guidelines for managing diabetes in Ramadan. Diabet. Med. 2016; 33: 1315–1329.
6. Ibrahim M, Abu Al Magd M, Annabi FA, et al. Recommendations for management of diabetes during Ramadan: update 2015. BMJ Open Diabetes Research and Care 2015;3: 1-10
7. The Muslim Council of Britain. MCB. Ramadan and Diabetes: A guide for patients. June 2013. Available at: http://www.mcb.org.uk/wp-content/uploads/2014/06/Ramadan-and-diabetes-A-guide-for-patients-2013.pdf. Last accessed on: 16/05/2018.
8. International Diabetes Federation, IDF. Diabetes and Ramadan International Alliance, DAR. Diabetes and Ramadan: Practical Guidelines. April 2016. available at: http://www.daralliance.org/daralliance/wp-content/uploads/IDF-DAR-Practical-Guidelines_15-April-2016_low.pdf. Last accessed on: 16/05/2018.

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