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Wednesday, October 04, 2006

Diabetes Management during Fasting

Fasting is common amongst Muslims, Hindus, and Jains. There could be instances in other religions as well, which I do not know! Glucose metabolism knows no boundaries of faith, so medically, the best fasts are the ones in which some beverages and limited foods are allowed. I like the ones which let you drink milk, and eat apples, some nuts and the like. Unfortunately, I cannot have my way much of the time, so many people are forced or feel compelled to fast without even water. Mahatma Gandhi fasted to fight for freedom, and as a non-violent weapon for social change, rather than because of directives from priests: his secular leanings however, did not spare him from the ill-effects of depriving his body of essential nutrition for long periods!

It is possible though difficult for people with diabetes to fast safely. The main concern is to prevent blood glucose from falling too low (hypoglycemia) during a fast, and to prevent blood sugar from zooming up (hyperglycemia), when delicious food and sweet beverages are placed before us once a fast is over!

Dosages of oral medicines and of insulin prescribed for diabetes control have to change when we fast, and it is important to ask a doctor for these changes before a fast commences.

A doctor may ask you to curtail some activities if you have diabetes and decide to fast. Do not go for a run, or try your hand at some sport when fasting in any case! This may sound frivolous but the truth is that people with diabetes may experience a sudden and severe blood sugar drop if their bodies have to take a sudden work load during a fast.

Ask your doctor to adjust dosages of diabetes medicines

Try to start the day with a nutritional meal and sugar-free beverages before a fast commences

Curtail physical activities during a fast

Do not gulp large amounts of sugary drinks to break a fast

Avoid over eating and fatty food after a fast is complete

Muslims start a fast with a meal before the day begins. This is an excellent method of fasting for people with diabetes, because a nutritious meal with plenty of sugar-free fluids, foods rich in complex carbohydrates and fibers, can keep a body replete with an adequate and steady stream of blood glucose for many hours in to a day. People with diabetes can take modified release forms of oral medicines and long acting forms of insulin with such pre-dawn meals.

Beverages laden with sugar are not the best ways to break a fast, especially if drunk quickly and in copious amounts. They tend to make blood glucose rise too rapidly. Similarly, it is tempting but harmful to eat too much, and to indulge in rich and fatty foods after a long period of abstinence.

Please leave a post here or send me an email if you would like some meal and drink suggestions which will go well with diabetes and fasting.


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