Dubai, United Arab Emirates, Dubai, June 25, 2015: The Dubai Health Authority’s Twitter Clinic @DHA_Dubai, highlighted today precautions for diabetics who fast during the holy month of Ramadan.

The panel of experts at the clinic included specialists from Dubai Hospital and the Dubai Diabetes Center, a specialised multi-disciplinary diabetes care and management centre.

Health tips were disseminated to more than 70,000 users who follow DHA on twitter.

Dr M. Hamed Farooqi, endocrinologist and director of the Dubai Diabetes Centre, said:  “The most important step for any diabetic who chooses to fast is to ensure he visits his health practitioner so that the doctor can advise whether it is safe for him to fast and to gauge whether his body will be able to manage long hours of fasting. Once that is ascertained, the patient needs to modify the medication dosage- usually lower the dosage- to ensure they maintain their sugar levels and avoid hypoglycaemia (low blood sugar reaction). Additionally, diabetic patients need to be on a proper meal plan and drink plenty of water during the non-fasting hours.”

The DHA endocrinology and diabetes centres meet with patients prior to the holy month of Ramadan to check if the patient is medically capable of fasting as well as to adjust their medication and provide an individualized diet plan.

Farooqi added that self-monitoring of blood sugar is not only permitted but also essential during fasting and should be effectively utilized to avoid hypoglycaemia or hyperglycaemia, especially during the first few days of fasting.  He said: “During the first week, it is advisable to monitor the blood sugar multiple times a day, based on the advice of your physician. Recommended times are-when the patient wakes up, later in the afternoon, before Iftar, two hours after Iftar and at Suhoor so as to understand the pattern of their blood sugar levels and to adjust their medication if needed. If the sugar level is erratic, the patient should visit their doctor.”

Farooqi elaborated: “Self-monitoring of sugar, timely medication and right diet are all steps that diabetics need to take especially since their body does not have the ability to control fluctuations in blood sugar level.  They also dehydrate faster especially when their sugar levels rise, therefore they need to ensure they take sufficient precautions to maintain their sugar levels while fasting.

“Diabetics who are insulin dependent, i.e. primarily type 1 diabetics are considered to be high risk groups and usually we advise them not  to fast as permissible by the religion because they are at a higher risk of developing hyper or hypoglycaemia. Yet, we find that there are some patients who insist on fasting. For such patients, our advice is to work very closely with their treating team of health professionals to avoid any major health problems such as very high blood glucose levels as well as rise in ketone levels in the body that may lead to a diabetic coma. Type 2 diabetics can fast after adjusting their medication in consultation with their doctor and following all the recommendations.

“A drop or rise in the sugar level for diabetics can cause symptoms, like weakness, shaking of the hands, difficulty in speech, heart palpitations etc. Therefore as a precaution, all diabetics should always have a sugar source at hand that is fast-acting such as glucose gel or tablets, fruit juice, sugar or honey which they need to consume, if they are experience low sugar.”

Inaam Kandil, head of diabetes education at Dubai Diabetes Centre, said: “Fasting requires the mind and body to adjust and adapt to the new routine and to make sure this is a smooth transition, preparation is key. Therefore, in addition to medication, they need to prepare meal plans very carefully.”

Children with diabetes and fasting:

Dr Asma Banjab, paediatric endocrinologist at Dubai Hospital, said: “Most children with diabetes have type 1 diabetes and type 1 diabetics should generally avoid fasting as they fall under the high-risk category. As healthcare professionals, we strongly advice family members to refrain from allowing their children with type 1 diabetes to fast.

“However, we find that some of them insist on fasting.                                                                                              

“In case of type 2 diabetes, children can still fast, provided they take all necessary precautions and visit the healthcare professional prior to fasting as well as follow-up during fasting.

 “Type 1 diabetic patients, who insist on fasting, need to take lots of precautions. They need to closely follow-up with the multidisciplinary healthcare professionals prior to fasting to adjust their insulin dosage and chalk out a meal plan as well as throughout the fasting period to ensure they are on the right track and that they are going fine.

“These children must always have a sugar source with them, their parents should monitor their blood sugar level few times a day as advised by the doctor and at any point if their blood sugar level drops to 70 or below they should break the fast with a quick-acting sugar and then re-check the blood sugar after ten minutes to ensure it is above 70 so that they can have their meal.

“If their blood sugar goes high, that it above 250, they have to check their ketones in the blood and urine and if the ketone level is high, they should break the fast and seek medical advice immediately.

“During the fasting hours, if they experience any discomfort, they should immediately check their blood sugar and decide accordingly.

“They should avoid any strenuous activity that causes exhaustion especially during the fasting period.”