Risks Among Diabetic Patients Fasting in Ramadan
All diabetic patients should know the symptoms of hypoglycemia which include :
a) Shaking, tremor
b) Sweating
c) Anxious
d) Dizziness
e) Hunger
f) Fast Heartbeat / palpitation
g) Impaired vision
h) Fatigue / Weakness
i) Headache, poor concentration
j) Irritable
There is significant increased risk associated with fasting among diabetic patients. ( Reference: DiabetesCare ,America Diabetes Association, ADA)
a) Severe Hypoglycemia :- EPIDIAR study showed that fasting during Ramadan increased the risk of severe hypoglycemia (defined as hospitalization due to hypoglycemia) as 4.7-fold from 3 to 14 events/100 people /month in type 1 diabetes while 7.5-fold in patients with type 2 diabetes from 0.4 to 3 events/100 people / month.
b) Hyperglycemia:-. The extensive EPIDIAR study showed a x5 fold increase in the incidence of severe hyperglycemia (requiring hospitalization) during Ramadan in patients with type 2 diabetes (from 1 to 5 events /100 people / month) and an approximate x3 fold increase in the incidence of severe hyperglycemia with or without ketoacidosis in patients with type 1 diabetes (from 5 to 17 events/100 people/ month) .Hyperglycemia may have been due to excessive reduction in dosages of medications to prevent hypoglycemia. Patients who reported an increase in food and/or sugar intake had significantly higher rates of severe hyperglycemia .
c) Diabetic Ketoacidosis:- Patients with diabetes, especially those with type 1 diabetes, who fast during Ramadan are at increased risk for development of diabetic ketoacidosis, particularly if they are grossly hyperglycemic before Ramadan. In addition, the risk for diabetic ketoacidosis may be further increased due to excessive reduction of insulin dosages based on the assumption that food intake is reduced during the month.
d) Dehydration and Thrombosis:- As a result of limitation of fluid intake during the fast, especially if prolonged may lead to dehydration which can be severe in hot and humid climates and electrolyte depletion. Orthostatic hypotension may develop, especially in among individuals who perform hard physical labor, all conditions that result in excessive perspiration. In addition, hyperglycemia can result in osmotic diuresis and contribute to volume patients with preexisting autonomic neuropathy. Syncope, falls, injuries, and bone fractures may result from hypovolemia and the associated hypotension. In addition, contraction of the intravascular space can contribute to a hypercoagulable state.
————————————————————————
Dr. Sloan, MD., is a qualified practicing medical doctor with a passion for the promotion of a healthy lifestyle and the prevention of illnesses and diseases. Subscribe for his newsletter containing solid information and advice at http://www.drsloanmd.com.
========================================
