Tens of thousands of Muslims in Calgary begin a month of fasting as Ramadan begins.
But Muslims with diabetes may find Ramadan and its religious obligations, including daily fasting, particularly difficult to manage.
They must be very careful with medications, diet and blood sugar control.
But doctors say fasting, one of the five pillars of Islam, is still possible for some people with type 2 diabetes. Some may fast easily, others may fast cautiously, or not at all. according to Dr Fauzia Moyeen – but she said people with type 1 diabetes can’t even try fasting.
“We have worked tirelessly over the past month to raise awareness among communities, doctors and nurses,” said Moyeen, a diabetologist and international diabetes trainer who developed the disease herself two years ago.
“First, we need to train people with diabetes to stay in close contact with their doctor, educators and pharmacists during Ramadan,” Moyeen said.
Diabetes is a disease in which the body does not produce insulin, the hormone that controls blood glucose, or does not properly use the insulin it can produce.
In addition to issues with blood sugar regulation, overeating when breaking the fast at the end of the day can also be a problem, being tempted by sugary treats and rich foods, says Moyeen.
She says people with type 2 diabetes who want to fast should assess their risk before doing so, through their family doctor.
In Islam, children, the elderly, pregnant and nursing women, and sick people are exempt from fasting. But some still want to fast to some extent.
Moyeen says changing expectations, such as fasting fewer days than everyone else and avoiding problem foods, can make this possible.
“Those who still want, we help them,” said Moyeen. “They also need to have a discussion with their doctor.”
Family doctor Dr Mukarram Zaidi says Muslims with diabetes should always contact their doctor before Ramadan to discuss a plan.
“In Islam, it’s okay not to fast if your family doctor tells you it’s okay,” Zaidi said.
Zaidi says Ramadan is not about forcing people to fast.
“They have to do blood work first and their doctor is the best person to tell them if they can fast,” he said. “Also see if their medications can be adjusted for Ramadan.”
Zaidi says patients should track their calorie intake and avoid high glycemic foods and foods high in sugars and fried foods, opting for slower-release carbs, like wholegrain bread and rice.
Ramadan lasts the whole month of April.