How diabetic patients can fast safely this Ramadan amid Covid-19

Religious organisations and medical associations have confirmed that the intake of medications does not count as breaking fast

Muslims living with diabetes amid the Covid-19 pandemic have to strike a balance between fasting during Ramadan and keeping up with their medications and vaccination.

Here are some tips from Dr Shailendra Bajpai, regional medical director for greater Asia (Apac) at US medical technology company Becton, Dickinson and Company, on how patients with diabetes can fast safely.

Adhere to your treatment as prescribed

To keep your blood sugar levels under control, diabetes medication must be taken as prescribed.

Make sure you always have access to your medication - supply, refill and access to a healthcare provider in any emergency situations.

This may include optimal use of telemedicine/telehealth platforms for routine tele-consultations.

Religious organisations and medical associations have confirmed that the intake of medications to relieve any discomfort (which may occur due to vaccines and consumption of medication during the period of fasting) does not amount to breaking the fast - diabetes patients should in fact break the fast if they feel unwell.

For patients on insulin injections, practising proper insulin injection techniques is vital to maintain glycaemic control.

As recommended, 4mm pen needles are the perfect length to penetrate the skin and enter the fat layer. This allows patients to receive the required insulin dosage with minimal risk of intramuscular injection.

Other injection techniques include choosing the right injection site (abdomen, upper thighs, buttocks or upper arms), practising regular site rotation and disposing of insulin pen needles after use.

With the right injection techniques, along with the correct tools, patients will have improved glycaemic outcomes to ensure they can fast safely this Ramadan.

Maintain a healthy diet

Seek nutritional advice from your healthcare professional on Ramadan and what fasting entails for your body, and practise portion control during meals.

It is essential to know what food to consume and in what quantities.

For instance, patients should consume an adequate amount of daily calories - divided between iftar (breaking of fast) and suhur (morning meal before sunrise).

Patients must also stay hydrated by drinking enough water and non-sweetened beverages during, or in between, the two main meals.

Get your Covid vaccination This is especially so for patients with diabetes, who have relatively compromised immune systems and are more susceptible to severe illnesses.

Many religious organisations and medical associations have ascertained that receiving the vaccination during Ramadan does not count as breaking fast.

Diabetes patients should discuss with their healthcare professionals or look for local resources about pre-booking their vaccination appointments and determining the optimal time for vaccination, such as a couple of hours before iftar.

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Regular monitoring of blood glucose levels

Diabetes patients must do so more often than usual when fasting.

This is also important for pregnant women - diabetes in pregnancy is associated with an increased risk of hyperglycaemia and hypoglycaemia - as well as the elderly, especially those who have lived with diabetes for a prolonged period and who may have comorbidiy that impact the safety of fasting.