Contents:
- Medical Video: Diabetes: Know Your Numbers
- Can diabetics fast?
- What should be considered by diabetics when fasting?
- How to undergo diabetes treatment while fasting?
- Oral anti-diabetes medication
- Insulin
Medical Video: Diabetes: Know Your Numbers
Ramadan fasting is considered to have a good effect on health. However, in patients with chronic diseases such as diabetes, fasting without consulting a medical officer can be dangerous, because side effects of diabetes can arise or from the anti-diabetes drugs they consume. Here are tips for diabetics to keep fasting safely.
Can diabetics fast?
Based on the guidelines made by The International Islamic Fiqh Academy and The Islamic Organization for Medical Sciences, diabetics are divided into 4 categories based on whether or not they are fasting:
1. Low risk, may fast
- Healthy patients with diabetes controlled by diet and drugs
- HbA1C levels <7%
2. Medium risk, can run fast carefully
- Healthy patients with diabetes controlled by diet, medication or short acting insulin
- HbA1C levels <8%
3. High risk, allowed not to fast
- Value of fasting blood sugar or blood sugar before fasting 150-300 mg / dl
- HbA1C level 8-10%
- Have microvascular complications (retinal, kidney, nerve) or macrovascular disorders
- Stay alone or get sulfonylurea or insulin therapy
- Elderly patients over 75 years old
- Patients with reduced memory function, dementia, or treatment that affects memory
- The presence of severe comorbidities, such as heart failure, stroke, cancer, or uncontrolled high blood pressure
4. The risk is very high, not fasting
- Examination of high blood sugar, with an average value of fasting blood sugar or blood sugar before fasting> 300 mg / dl
- HbA1C levels> 10%
- Severe hypoglycemia over the past 3 months
- Recurrent hypoglycemia or hypoglycemia with no known cause
- Complications of diabetes ketoacidosis or hyperosmolar hyperglycemia
- Type 1 diabetes
- Acute illness
- Heavy physical workers
- Is pregnant
- Patients with reduced memory function, dementia, or treatment that affects memory
- Patients on dialysis (dialysis)
What should be considered by diabetics when fasting?
There were no changes in food during Ramadan fasting. Diabetics are encouraged to consume foods that produce energy slowly, such as wheat, beans, rice, and semolina, as well as avoid foods with high saturated acid content. The portion of food during fasting is also adjusted, which is 50% at dawn, 40% when breaking fast and 10% after tarawih. Also make sure the fluid intake when fasting is properly fulfilled after breaking fast and tarawih.
Low and moderate physical activity can still be done by people with type 2 diabetes, but it is necessary to modify the duration and intensity because excessive physical activity can cause hypoglycemia for people who are fasting. Tarawih must be considered as physical activity when modifying activities.
Needling into the skin for blood sugar testing does not cancel fasting. So, check your blood sugar regularly, especially if you feel pain or there are symptoms of low or high blood sugar. Diabetics are encouraged to cancel fasting if the blood sugar level is <70 mg / dl or> 300 mg / dl.
How to undergo diabetes treatment while fasting?
Oral anti-diabetes medication
- Change the dose of metformin 3 x 500 mg to 2 x 1000 mg
- Sulfonylurea drugs are not recommended or should be used with caution
- If it is still used, reduce the sulfonylurea dose to half
- Use of SGLT2 drugs is not recommended
- TZDs, alpha glucosidase inhibitors or incretin drugs can still be used
Insulin
- The use of insulin premixed or intermediate insulin work is replaced twice a day in medium-acting insulin which is used at night and insulin works quickly along with eating
- Use the recommended dose of insulin when breaking and half the dose at dawn
- Insulin pump: consider reducing basal doses and modifying bolus doses when breaking fast and dawn
Treatment of diabetes when fasting must be adjusted, because if not, complications can occur such as severe hypoglycemia which of course can be dangerous. Consult your doctor for more information.
