Patients can safely fast by taking advice from healthcare professionals
Management of Diabetes and Hypertension
Karachi: The Pakistan Cardiac Society, Karachi Chapter, recently organized an awareness seminar on managing diabetes and hypertension for individuals with these conditions during the month of Ramadan. Held at the Federation of Chamber of Commerce and Industry, the event aimed to educate people ahead of Ramadan, ensuring they could fast safely while effectively managing their health. The initiative was led by Dr. Akram Sultan, Coordinator of the Karachi Chapter, who emphasized the rising prevalence of diabetes and hypertension. He urged patients to consult healthcare professionals for guidance on safe fasting.
Pakistan Cardiac Society Karachi Chapter organized a Pre-Ramadan awareness session on Diabetes and Hypertension at Federation of Chamber of Commerce and Industry Karachi recently. Group photograph taken on the occasion shows the speakers with some of the participants and organizers.
Dr. Akram Sultan highlighted that pre-Ramadan education plays a crucial role in reducing morbidity and mortality. He stressed the importance of understanding how to prevent diabetes, manage high blood pressure, reduce the risk of heart attacks, recognize emergencies during Ramadan, and prevent sudden deaths.
Dr. Benish from Civil Hospital Karachi, the first speaker, referred to diabetes and hypertension as silent epidemics requiring collective attention. She emphasized the need for regular medical checkups and maintaining a balanced lifestyle. Consulting a doctor before Ramadan can help manage these conditions effectively. She advised patients to monitor their blood pressure and blood sugar levels while following a healthy diet.
Dr. Saiful Haque from BIDE discussed essential clinical care during Ramadan. He addressed common concerns, such as whether fasting is safe for diabetic individuals. Doctors assess risk factors before advising patients on fasting. With around twenty million adult Muslims fasting worldwide, evidence-based guidelines are now available for safe fasting. Studies from different countries help doctors determine risk factors and recommend precautions. He cautioned against turning fasting into feasting, a common issue during Ramadan, and emphasized weight management and education to reduce hypoglycemia risks. Pre-Ramadan assessments should focus on patient education, risk stratification, medication adjustments, and recognizing emergency symptoms. Blood sugar levels should ideally remain between 100-200 mg/dL, and fasting should be broken if levels drop below 70 mg/dL.
Regarding medication, Metformin generally does not require dose adjustments, but other diabetes medications like Acarbose, DPP4 inhibitors, and TZDs may need modifications. Often, the morning dose is switched to the evening and vice versa. Insulin therapy may require a dose reduction of up to twenty units if blood sugar is well controlled.
Some of the participants of the Pre-Ramadan awareness seminar organized by Karachi Chapter of PCS at FCC&I House photographed with Dr. Akram Sultan the organizer of the meeting.
Dr. Rooh Ilyas discussed cardiac arrest and sudden death, explaining that if a patient remains unconscious for over an hour but survives, it is classified as cardiac arrest. Individuals with a history of heart disease face a higher risk of heart attacks and sudden death. She clarified that not all sudden deaths result from heart attacks. Immediate medical attention is crucial for chest pain or tightness, as timely intervention through angiography or angioplasty can save lives. About 80% of sudden deaths are linked to coronary artery disease, and a blunt blow to the chest can also cause sudden death.
She further explained that diagnostic tests such as ECG, echocardiography, and treadmill tests help assess cardiac health.
Cardiac arrest management requires CPR, which all adults should learn. In emergencies, calling for medical help is essential, and an Automated External Defibrillator (AED) should be readily available in public places. Until medical assistance arrives, ensuring an open airway, breathing, and circulation is critical. Blood circulation stoppage to brain for just ten minutes can lead to severe complications. Implantable cardiac devices can also help prevent sudden deaths, with Acute Myocardial Infarction being the leading cause.
Prof. Nawaz Lashari stressed the importance of a balanced diet and regular exercise for overall well-being and quality sleep. He advised against unnecessary stress, which increases the risk of diabetes and hypertension. Recognizing risk factors is vital, and in case of chest pain, taking a soluble aspirin immediately can be lifesaving, reducing death risk by 23%. He also cautioned against taking blood pressure medication when BP is low and emphasized avoiding dehydration during Ramadan. He noted that Civil Hospital Karachi provides free cardiac care facilities.
Mr. Atif Iqbal, Chief Executive of High Q Pharma, advised attendees to consult doctors before Ramadan and try fasting for three days as a trial. He stressed the importance of maintaining a healthy weight, especially for individuals over 45, and ensuring regular medical checkups. Family history plays a crucial role in risk assessment. Regular blood glucose monitoring, avoiding fast food and sugary drinks, and consuming dates in moderation can prevent complications.
Dr. Asadullah Khan discussed heart failure management and highlighted the growing popularity of intermittent fasting for health benefits. Prof. Khalida Soomro and a representative from the Pakistan Medical Association (PMA) also shared their insights.
It is important that speakers at such awareness sessions should avoid medical jargon, use simple language, and focus on key take-home messages for better public understanding.
