Category: General

Before and after fasting include high fibre foods such as wholegrain cereals, granary, bread, brown rice, beans and pulses, fruit, vegetables, and salads. These should be slowly absorbable carbohydrates with a low glycemic index.

It is good to break the fast with a glass of milk and dates. A sensible portion is 2 dates. Dates are a source of energy and fibre. This should be followed by a balanced meal which includes wheat/rice, vegetables, fish (or lean meat), fruits and nuts. Remember to take the prescribed medications also along with the meal. Drink plenty of water to avoid dehydration which is a complication of Ramadan fasting. Dehydration can lead to headaches.

High sugar / high fat foods e.g. Indian sweets such as Ghulab Jamun, Rasgullay, Balushahi, Baklawa etc are preferably avoided during the Iftar. Milk-based sweets and puddings such as Rasmalai, Barfee etc are preferred. High fat cooked foods such as parhattas, oily curries, greasy pastries are better avoided.

These can be replaced with chapattis made without oil, baked or grilled meat and chicken. It may also be worth avoiding the caffeine content in drinks such as tea, coffee and cola(Caffeine is a diuretic and stimulates faster water loss through urination).

(Information courtesy: NHS Ramadan Health Guide)

Essentially medicines like Metformin, Sitagliptin, Vildagliptin, Saxagliptin and Linagliptin do not produce significant hypoglycemia (low blood sugars) by itself. Metformin acts by utilizing the existing insulin in the body and gliptins by stimulating the pancreatic beta cells in phased manner.

However if this is combined with Insulin or other diabetic medications, they may result in low blood sugars. Do not change or stop medications without meeting your doctor.

High blood sugars during fasting can happen if the subject had a high blood sugar to start with or if some medicines are reduced or discontinued. If sugars are beyond 300 mg/dl, there is a risk of diabetic ketoacidosis. Further you can experience increased urination, excessive tiredness, fatigue and infections if sugars increase beyond 300 mg/dl.

Low blood sugar values below 70 mg/dl can result in dizziness, drowsiness, hunger, perspiration and convulsions. If your sugars are found to be below 70 mg/dl or above 300 mg/dl, it is preferable to break the fast and contact your health care provider. If the blood sugars are below 70 mg/dl, consume 150 ml of fruit juice or 2 glucose tablets and top it up with a snack.

Subjects with heart disease including angina and heart failure may have regular medicines to take during the day. It is preferable not to fast if it seems to interfere with normal consumption of medicines or lifestyle changes. Similar with stroke and kidney disease, a medical opinion should be strictly sought before attempting to fast. If you happen to experience any new symptoms suggestive of your disease, you need to consult your doctor as soon as possible.

These medications have high risk of hypoglycemia (low blood sugars) during prolonged fasting. You could still fast while being on these medications but your physician will help you time the doses of medications. The doses may need to be reduced or replaced by tablets that do not produce hypoglycemia.

Hypoglycemia during fasting is quite dangerous. You should be breaking the fast if you see blood sugar values below 70 mg/dl or see falling blood sugar values on monitoring.