PETALING JAYA: On average, Muslims in Malaysia fast for 13 hours a day during Ramadan.
However, for those with diabetes, abstaining from food and water all day can increase the risk of hypoglycemia, a condition where the blood sugar or glucose level drops below the normal range.
Endocrinology and diabetes consultant physician at KPJ Damansara 2 Specialist Hospital, Dr Sharifah Faradila Wan Muhammad Hatta, said patients with health problems, especially diabetes, could be exempted from fasting.
“However, many Muslims with diabetes feel committed to Ramadan and insist on fasting, so they are advised to consult their doctor and practise fasting before the start of Ramadan,” she said.
She also advised patients to pick the food and drinks they wish to consume for the predawn (sahur) and breaking of fast meals carefully to ensure they are able to keep their blood sugar levels steady and get the vitamins and nutrients they need, Bernama reported.
Dr Sharifah Faradila said hypoglycemia was a dangerous condition in which the glucose level drops below the normal range of 4 millimoles per litre (mmol/L), adding that patients with Type 1 and Type 2 diabetes were at high risk of developing this condition.
“They must break their fast immediately if their blood glucose level drops below 4mmol/L and treat it by consuming 15-20g of carbohydrates such as fruit juice or four to five jelly babies (a type of candy), followed by something starchy such as a sandwich,” she said.
If left untreated, severely low blood sugar can be life-threatening and can lead to complications such as multiple organ failure, cardiac arrest, permanent brain damage and coma.
According to Dr Sharifah Faradila, on average in Malaysia, one in five adults lives with diabetes.
There are three main types of diabetes, namely, type 1 and type 2, and gestational diabetes, which occurs in certain pregnant women.
She said diabetic patients were advised to check their blood sugar levels frequently throughout the day if they chose to fast during Ramadan.
Pointing out that it is important for diabetic patients to eat a healthy and balanced diet during Ramadan, Dr Sharifah Faradila said it was advisable for them to eat foods such as brown rice, beans and wholewheat bread that have a low glycaemic index, contain high amounts of fibre, and release energy slowly before and after fasting.
“They must not skip the sahur meal and have it as close as possible to the cut-off time because it will be more than 13 hours before they can break their fast,” she said.
Meanwhile, KPJ Damansara 2 Specialist Hospital consultant gastroenterologist and hepatologist, Dr Jaideep Singh, said the most common problems of the digestive system endured during Ramadan were acute gastritis and GERD (gastroesophageal reflux disease).
These are caused by prolonged fasting and are seen most in those who already have gastric problems, and the consumption of large fatty meals and spicy food while breaking fast worsens their symptoms.
He said these problems could be prevented by drinking enough water for hydration, eating small amounts of food frequently, avoiding smoking and taking gastric medications as prescribed.
“But avoid fizzy drinks as they contain too much sugar and the gases from sugar fermentation may cause bloating.
“Avoid overeating because eating a big meal suddenly can cause stomach ache and severe acid reflux.
“Also, try to avoid sleeping on a full stomach and allow enough time for the undigested food to go through the stomach and gut adequately.
“Avoid too much chili, hot spices, fried and oily food, as well as junk food,” he added.
