Ramadan 2023: Manage sugar levels, especially while fasting for long periods

Think about the aroma of newly baked bread, the sizzle of grilled meats flavoured with spices, and the sight of vibrant colours bursting from each dish. That is the main focus of iftar.

Ramadan, however, is a celebration that encompasses much more than just food. It's a time for spiritual development, for getting back in touch with one's religion, and for being kind and compassionate to others. In order to concentrate on your inner self instead of food or drink, you can also fast for 30 days from sunrise to sunset.

With Ramadan drawing near and 'iftari' preparations on the mind, it is crucial to think about the best ways to support diabetics and those who care for them in fully celebrating the holiday. Navigating a fast can be challenging because it requires a significant shift in routine and way of life, which can make it challenging for people to maintain normal blood sugar levels throughout the day. In order to comprehend any risks and have a strategy in place to manage your diabetes as effectively as possible, it can be very helpful to consult your doctor before fasting.

Dr Shehla Shaikh, Consultant Endocrinologist, Saifee Hospital, Mumbai said: "For people with controlled diabetes, there are steps they can take to manage their sugar levels, especially while fasting for long periods during Ramadan. There are several healthy eating habits people should follow for the periods between 'sehri' and 'iftar'. Don't forget to monitor your blood sugar during your fast; you can do this effortlessly while on the go as there are now Continuous Glucose Monitoring (CGM) device options available in addition to conventional blood glucose metres that require finger pricking. Taking one's doctor's advice is also important to understand any changes required with their medication."

When it comes to managing diabetes while fasting, using metrics like time in range through a CGM monitor can be very beneficial. The proportion of time that a person's blood glucose levels are within a given range (typically 70 to 180 mg/dl) is known as time in range. A longer period of time in the target range is linked to more frequent blood sugar checks, which can help you maintain better glucose regulation and lower your risk of developing long-term health issues. One should try to be within range for roughly 17 of each day's 24 hours. In addition, there are a few important considerations for diabetics to bear in mind as they observe Ramadan.

Here are a few tips to manage your diabetes while you observe Ramadan this year:

Have an energy-boosting Sehri (pre-dawn) meal: Include more fibre-rich starchy foods that release energy slowly, from oats and multigrain breads to brown or basmati rice, along with vegetables, lentils (dal), and more. You can also have proteins like fish, tofu, and nuts for energy. Drink plenty of fluids, but avoid sugary or highly caffeinated drinks like coffee, soft drinks, and more.

Regularly monitor blood sugar levels: Checking your glucose levels more frequently is a must, and there are more ways to do this in the comfort of your own homes. Continuous Glucose Monitoring (CGM) wearable devices, like FreeStyle Libre, provide a simple option for people with diabetes to access real-time glucose readings and trends, such as while you were fasting or at the time of Iftar. This is all while avoiding the pain of pinpricks that come with traditional glucose testing options.

Properly replenish during Iftar (breaking of fast): The fast is traditionally broken with dates and milk, which you can follow with complex carbohydrates. Make sure to hydrate yourself as well. Consume sweet and fried or oily foods in moderation, as these can affect your health. Fruit before bedtime can also help maintain sugar levels until early morning.

Follow a gentle exercise routine: Keep up physical activity but reduce the intensity to avoid extra exertion. You can try simple workouts, walking, or yoga. Resistance training can also help you avoid muscle loss and build strength at this time.

Sleep well: Adequate hours of sleep - of good quality - are key to good health and wellness. Especially during Ramadan when your pre-dawn meal is key to sustain your energy, getting enough sleep is key. This also helps avoid sleep deprivation, which can impact your hunger. This can also support metabolism and help regulate blood glucose levels, which is critical when managing diabetes.

In addition to following these suggestions, diabetics should be vigilant for any worrisome trends of hyperglycemia or hypoglycemia and take quick action. The key to this is coming up with a strategy for what to do if your blood sugar levels are too high or low during, before, or after fasting. It's also crucial to follow your doctor's recommendations on how to keep your blood sugar levels in the goal range for at least 75 per cent of the day, even when you're fasting.

Having a strategy in place can help you manage your health during Ramadan, even though some diabetics choose to fast during this holy month.