COVID19 patients can fast safely in Ramadan in consultation with their physicians even if they are diabetic


Ramadan & Diabetes Online Conference by BIDE
COVID19 patients can fast safely in Ramadan
in consultation with their physicians even
if they are diabetic
Experts in various disciplines besides Religious
scholars from many countries share their views on safety
measures and precautions to be observed by patients

By Dr. Musarrat Riaz

KARACHI: Baqai Institute of Diabetology & Endocrinology (BIDE) in collaboration with Ramadan & Hajj Study Group recently organized 6th international Diabetes & Ramadan online conference. Renowned health care experts including diabetologists, endocrinologist, nephrologists, cardiologists, dietitian, as well as Islamic scholars and Ulema from various countries of the world including UK, UAE, Saudi Arabia, Qatar, Malaysia and USA participated in the conference and delivered lectures on safe fasting, especially in Ramadan.

The international & national experts agreed that there were thousands of (COVID 19) patients who are asymptomatic and in self isolation at homes not only in Pakistan but across the globe. These patients can fast safely (in Ramadan) in consultation with their physicians even if they are diabetic. However special precaution should be taken by these patients like maintaining social distance, staying at home, keeping hydrated by taking plenty of fluids after iftar, keeping their blood glucose under control and by taking their medicines regularly.

Prof. M. Yakoob Ahmedani Professor of Medicine and Head Ramadan & Hajj Study Group in his inaugural speech said that they were holding this conference regularly for the past several years to educate physician as well as general public regarding safe fasting so that they could remain healthy and fit during the holy month of Ramadan in order to achieve the physical, mental and spiritual benefits of Ramadan. This year the ramadan is arriving at a time when the whole world is affected by COVID-19 and millions of people with Diabetes, Hypertension, and CVS disease wanted to know if they could fast or not when they are asymptomatic or if they tested positive for the virus. To answer these questions we have gathered international and national experts to address these queries so that simple messages could be commitment to the patients.

 Prof. Yakoob Ahmedani in his presentation talked about benefits of fasting not only from spiritual point of view but quoted various studies which highlights the importance of physical and mental wellbeing as a result of fasting. He said that now a days not only Muslims observe fast, but non- Muslims also practice intermittent fasting because of the well documented benefits of fasting in literature. However diabetic patients should observe fast after consultation with their primary physicians.

Dr. Khaled Tayyeb from Saudi Arabia talked about Role of pre-Ramadan diabetes education and its importance for people who want to fast safely during Ramadan despite various medical problems. Education about hypo and hyperglycemia, importance and timings of self- monitoring of blood glucose, knowing when to break the fast and dietary modifications, are some of the key messages that should be given to every diabetic patient who intends to fast in addition to medicines and insulin dose adjustments.

Miss Salma Meher a renowned dietitian practicing in United Kingdom talked about Diet and lifestyle for people living with diabetes during Ramadan. In her presentation she gave simple and practical tips for diabetic people in order to modify their diet so that patients can fast safely without experiencing hypo and hyperglycemia. Avoiding deep fried foods as well as foods rich in carbohydrates and intake of low glycemic index foods at Iftar can help in preventing post iftar hyperglycemia which can lead to various complications post Ramadan. Regarding physical activity she said that if patients are offering Taraweeh prayers, they don’t need to do any extra physical exercise as it is equally effective. She concluded that Ramadan should not be considered as a month of Feasting but rather should be used to develop and practice healthy eating habits and modifying our lifestyle for the rest of our life.

Dr. M. Hasnain from United Arab Emirates is a world- renowned speaker and is the chairman of IDF-DAR Alliance which has developed guidelines for Diabetes and Ramadan. He talked about Fasting and Acute Emergencies. Talking about IDF DAR guidelines he described risk stratification of diabetic patients into various categories as low, moderate and high risk depending on various characteristics of patients as well as treatment modalities. He discussed in detail the acute emergencies during fasting like hypoglycemia, diabetic ketoacidosis (DKA) as well as dehydration and associated problems and how to avoid them. Patients at high risk of developing these complications should be counselled properly and advised not to fast.

Prof. Abdul Jabbar from UAE talked about use of insulin in diabetes during Ramadan. Various types of insulin that can be used safely along with dose adjustments during fasting was elaborated through practical case studies. As a general rule the morning dose of insulin is shifted at Iftar time while the evening dose is shifted to Sehri time with 30-50% dose reduction as per individual patients’ profile as well as the type of insulin being used. He also emphasized the importance of SMBGS and knowing when to break the fast.

Prof. Rayaz Malik from Qatar talked about SGLT2I efficacy and safety during Ramadan. He presented various studies in which safety of this relatively new compound in Ramadan has been documented with proven efficacy.

Dr. Saiful Haque talked about Covid19 Diabetes and Ramadan and emphasized the fact that most patients with Covid19 and diabetes who are asymptomatic and do not have any additional health issues can safely fast in Ramadan. However, all such patients should keep in contact with their physicians to adjust their medicines.

Prof. Muhammad Wasy a renowned neurologist in his talk about impact of fasting in Ramadan Stated that fasting has many beneficial effects on body and helps in prevention of various neurological conditions like stroke by enhancing immune system. The holy month of Ramadan should be used to gain benefits of fasting both physical and metal, he further pointed out.

Eminent Islamic scholar Mufti Taqi Usmani while addressing the conference participants emphasized the fact that in current situation of COVID-19 pandemic millions of people across the globe suffering from various diseases are looking towards health experts as well as religious scholars regarding whether they can fast safely or not. Mufti Taqi Usmani said that medical practitioners and health experts are in a better position to advise people whether they should fast or refrain from fasting according to the underlying medical conditions of the patients and in this regards patients should listen to their respective physician’s advice. He congratulated the organizers for holding such an important conference and bringing together medical experts and religious scholars on one platform for guiding the people.

Another eminent religious scholar Mufti Najeeb Khan said that fasting is one of the five pillars of Islam and fasting is obligatory for all adult Muslim men and women except for those who were seriously ill and those who were travelling. For patients suffering from various medical conditions advice of their physician is a must and they should listen to their doctors.

Responding to various queries he said that checking blood glucose levels, injecting insulin or getting pure oxygen is permissible during fasting and does not invalidate the fast. Several other experts who participated in the conference included Dr. Saud Al Sifri from Saudi Arabia, Prof. Mohammad Mafauzy from Malaysia, Dr. Uzma Khan from united States and Dr. Zahid Miyan from BIDE Pakistan. During the conference Ramadan and Hajj Study group, also launched a Meal book in Urdu language with calculated menus and different caloric needs for people with diabetes so as to make it easier for people to understand portion control and have a healthy and safe Ramadan.