As we are nearing the holy month of Ramadan, Muslims all over the world have started prepping for a month-long fast during the daylight hours. But what impact will this fast have on patients with chronic conditions? Let’s find out.
Muslims around the world fast for almost 29 to 30 consecutive days from dawn to dusk in a year during the month of Ramadan1. During this time, all those who fast go through changes in their dietary habits and sleeping patterns2. However, it must be kept in mind that fasting for prolonged hours or unhealthy fasting can cause complications among people with chronic conditions such as diabetes3.
Here are some of the most commonly seen complications of fasting among people with chronic conditions:
Studies show that fasting puts patients with type 2 diabetes mellitus at a higher risk of hypoglycemia4. Now, what is hypoglycemia and how does this affect you? Hypoglycemia or sudden drop in blood sugar levels occur in people with diabetes and must be treated immediately to get it back to the normal range. If the fasting continues for a prolonged period and the blood sugar stays low for too long, it can result in seizures or even coma5.
It is a state in which the level of glucose becomes too high in the blood leading to serious and life-threatening complications like damage to the eye, kidneys, nerves, etc6. During Ramadan, lack of diet control during the Iftar meal or unsupervised reduction of diabetes medications can lead to hyperglycemia7. Thus, it is important to stick to a healthy diet plan during Ramadan fasting.
When there is a build-up of ketones (chemicals produced when your body doesn’t have enough insulin) in the blood, it leads to diabetes ketoacidosis. Excess ketones make the blood acidic, and is an indication of uncontrolled blood sugar levels8. Studies have found that fasting accelerates the development of lipolysis and ketosis, and increases glucagon levels9, which can result in low levels of potassium, swelling inside the brain, fluid inside your lungs or even damage to your kidney10.
Dehydration and Thrombosis
Fluid restriction during the Ramadan fast may cause dehydration. The prolonged period of fluid limitation, especially in hot and humid regions, can lead to severe dehydration11. This dehydration can further increase blood viscosity (stickiness), which raises the chances of thrombosis or blood clots12. Thus, for a diabetic patient, it is important to stay hydrated and drink plenty of fluids during their no-fasting hours to prevent any complications.
People with chronic conditions should try and are allowed to opt-out of Ramadan fasting as this can sometimes result in serious medical complications. However, if you still decide to fast, discuss with your doctor and prevent these health complications from taking a toll on your Ramadan celebrations.
- Mohammad Hossein Rouhani L. Is Ramadan fasting related to health outcomes? A review on the related evidence [Internet]. PubMed Central (PMC). 2020 [cited 3 February 2020]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274578/
- Abolaban H, Al-Moujahed A. Muslim patients in Ramadan: A review for primary care physicians. Avicenna Journal of Medicine. 2017;0(0):0.
- Al-Hader A, Abu-Farsakh N, Khatib S, Hasan Z. The Effects of Ramadan Fasting on Certain Biochemical Parameters in Normal Subjects and in Type II Diabetic Patients. Annals of Saudi Medicine. 1994;14(2):139-141.
- [Internet]. 2020 [cited 3 February 2020]. Available from: https://www.endocrinologynetwork.com/t2-diabetes/type-2-diabetes-and-fasting-how-dangerous-could-it-be
- Hypoglycemia (Low Blood Glucose) | ADA [Internet]. Diabetes.org. 2020 [cited 4 February 2020].Available from: https://www.diabetes.org/diabetes/medication-management/blood-glucose-testing-and-control/hypoglycemia
- Mouri M, Badireddy M. Hyperglycemia [Internet]. Ncbi.nlm.nih.gov. 2020 [cited 4 February 2020]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430900/
- Raveendran A, Zargar A. Diabetes control during Ramadan fasting. Cleveland Clinic Journal of Medicine. 2017;84(5):352-356.
- DKA (Ketoacidosis) & Ketones | ADA [Internet]. Diabetes.org. 2020 [cited 4 February 2020]. Available from: https://www.diabetes.org/diabetes/complications/dka-ketoacidosis-ketones
- Y F. [Diabetic ketoacidosis during the Ramadan fast]. – PubMed – NCBI [Internet]. Ncbi.nlm.nih.gov. 2020 [cited 4 February 2020]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10868172
- Diabetic Ketoacidosis | Cedars-Sinai [Internet]. Cedars-sinai.org. 2020 [cited 5 February 2020]. Available from: https://www.cedars-sinai.org/health-library/diseases-and-conditions/d/diabetic-ketoacidosis.html
- Elhadd T, Al-Amoudi A. Recommendations for Management of Diabetes During Ramadan: Response to Al-Arouj et al. Diabetes Care. 2006;29(3):744-745.
- Diabetes and Fasting During Ramadan [Internet]. Hamad.qa. 2020 [cited 5 February 2020]. Available from: https://www.hamad.qa/EN/your%20health/Diabetes/Pages/Diabetes-and-Fasting-During-Ramadan.aspx