This article looks at religious fasting and its impact on the management of diabetes during periods of abstinence and fasting. There are other reasons than religion for abstinence and fasting, one of the commonest being weight loss and we will look at these another time. Two major religions, Islam and Christianity (many other religions also have fast periods), have periods of fasting around this time of year so, we will have a look at their fasting practices and then some of the general issues around diabetes and fasting. Many of you will have fasted before, so this article may be nothing more than a reminder, for those of you who have not, we hope it provides some helpful tips for staying safe and well during your fast.
Islam – Ramadan
The dates for Ramadan are calculated using the Muslim or Hijrī calendar. Ramadan is based on the ninth month of the lunar calendar, so this year it is expected that the fast of Ramadan will commence at sunset on 22nd April and will last until 1st May. Ramadan moves forward each year by about 11 days which means the length of fasting is greater in certain years than others.
During Ramadan it is expected that Muslims who participate will abstain from food, water, beverages, smoking, oral drugs and sexual intercourse from sunrise to sunset.
Christianity – Lent/Easter
Easter Sunday is celebrated on the first Sunday following the full Moon that occurs on or just after the spring equinox. Easter Sunday is a feast day following Lent. Although not followed by all Christian denominations, Lent lasts for 40 days, concluding on Maundy Thursday, immediately prior to Easter Sunday. This year, Lent is from 2nd March to 14th April and Easter Sunday is on 17th April. During Lent, certain days are regarded as fast days, and again have implications for people with diabetes.
People of either faith with diabetes may be exempted from fasting but the majority of people with diabetes do fast so run increased risks of health adverse effects, such as hypoglycaemia, hyperglycaemia, diabetic ketoacidosis and dehydration. Most of these are as a result of a reduction of food and fluid intake and the timing of meals. Both of the above are regarded as partial or intermittent fasting.
Diabetes and fasting
As you can imagine, if you have diabetes fasting can cause complications in managing the condition, some, arguably, more serious than others. The best first step is to speak to your doctor or diabetes nurse to discuss the potential risks and problems associated with fasting. This will help you to formulate a plan to manage the period of your fast. Things you may want to think about and discuss could include:
- Complications of diabetes such as poor vision or heart or kidney disease, can be aggravated by fasting and you may want to consider whether to fast or not.
- If you take insulin and/or certain tablets, you may need to think about changing the amount and timing of your insulin dose to control blood sugar levels. You may also need to change the type of insulin you are using, for example, pre-mixed insulins are not recommended during fasting.
Research has shown that both education about the effects of fasting and relevant advice can dramatically reduce the likelihood of problems occurring, both low and high blood sugar levels. High blood glucose levels can develop during a fast if you do not take prescribed medication or if you are less physically active than normal, which, in turn, could lead to diabetic ketoacidosis (DKA) – a serious condition requiring hospital treatment.
If you are still happy to proceed with your fast then there are some simple, common-sense tips ad tricks to help manage your diabetes:
- Before starting the fast, you should eat foods containing slowly absorbed carbohydrates, such as rice, dhal, potatoes and pasta, along with fruit and vegetables.
- You should check your blood glucose levels more often than you normally would.
- When you break the fast, have only small quantities food and avoid eating only sweet or fatty foods.
- Try to eat just before the break of dawn, when you commence the next day’s fast.
- At the end of fasting, you should drink plenty of sugar-free and decaffeinated fluids to avoid being dehydrated.
Above all – Stay safe and well!!!