Diabetic patients may fast during Ramadan with several notes, namely making preparations a month or two before entering the holy month.
Diabetic patients are allowed to fast, fasting improves their glycemic control. But one or two months before fasting, it is better for diabetic patients to consult with their doctor on how to improve their glycemic control.
Diabetic patients should train themselves with sunnah fasting before entering Ramadan. Fasting training before Ramadan is important because there will be many changes experienced by diabetic patients when carrying out obligatory fasting in the holy month.
When a diabetic patient fasts, of course there are many changes, their eating patterns change, physical activity is also minimal, and this affects the condition of glucose in the blood.
During the preparation period, the doctor will assess the risk stratification. Then, the doctor determines whether the patient has a high risk or a low risk if fasting.
High-risk patients, for example patients who use insulin, have poor glycemic control, their blood sugar is above 300, their HbA1c is uncontrolled, of course they need modifications, both in their diet and their medication.
Keep Controlling Your Food Intake During Sahur and Iftar
Fasting is also not recommended for diabetes patients who have the potential to experience bad things if they do it.
What diabetic patients should pay attention to is that there are risks that will occur later if the patient fasts. Their blood sugar can become very low (hypoglycemia) or even spike (postprandial hyperglycemia).
Blood sugar levels can spike if food intake is not controlled after breaking the fast.
So, diabetic patients still have to set a meal schedule and be selective about their diet. For example, sahur with complex carbohydrates (rice, potatoes, corn) and break the fast with simple carbohydrates (1 to 2 dates).
Snacks After Tarawih
After breaking the fast with dates, diabetic patients can eat enough including rice, side dishes, and vegetables. If you still want to snack after tarawih, you can choose fruits.
After tarawih, you may still be given snacks, such as fruit.
No less important, patients must continue to diligently consult with their doctor, especially regarding changes to the schedule of the drugs they usually take.
Because there are some diabetes medications that will cause the risk of hypoglycemia, the sugar becomes very low.
Insulin Dose Modification
In addition to consulting about changing the medication schedule, patients also need to ask their doctor about modifying the insulin dose.
Those who use insulin, injections, must modify the dose, for example during sahur not given a dose as high as when breaking the fast. And the patient must also be given education on how to monitor blood sugar independently, especially during peak times of hypoglycemia.
The peak of hypoglycemia, for example, occurs at noon until approaching Asr or around 15:00. For example, at noon approaching Asr, hypoglycemia often occurs, he may monitor his blood sugar.
So, when do diabetes patients need to break their fast?
If blood sugar is below 70 then it is better to break the fast. And sports or physical activities should not be done close to the time of breaking the fast because it can also cause the risk of hypoglycemia, sports should be done after iftar (breaking the fast).
The article was created based on the Healthy Monday program in collaboration between EMC Healthcare and Liputan6, with resource person Dr. Angie Shabira Permata H, Sp.PD (Internal Medicine Specialist at EMC Cikarang Hospital).