Is fasting possible for diabetics, hypertensive?

Srinagar, Mar 2: The Ramadhan fasting can be a challenge and full of questions for people with diabetes and those on hypertension medications. Experts believe with proper medication adjustment, diet monitoring and watch on blood sugar and blood pressure levels, Ramadhan fasting could be possible for many patients.

With over 30 percent of adults in Kashmir hypertensive, a significant proportion of population is on hypertensive medications. The importance of healthy eating, and making the most of the month to discipline the meal intake is the need of the hour, doctors believe. Include adequate fruits, vegetables, proteins in the diet. Avoid sugar, reduce salt and measure your meals is the advice doctors have for people in general fasting during the holy month.

Dr Imran Hafeez, Additional Professor of Cardiology at SKIMS Soura said he always tells the patients to monitor blood pressure more regularly during this month. “If there is any major drop in BP, reduce medications,” he said. He said though there isn’t much evidence from randomised trials but, there is a consensus that fasting decreases blood pressure, both systolic and diastolic. He said it was also important to maintain proper hydration. “Ensure drinking enough fluids during Sehri and Iftaar. Avoid dehydration. I tend to avoid diuretics for hypertension in elderly patients this month,” he said.

However, he said, for heart disease patients, he generally advices to avoid fasting for moderate to high risk patients.

For diabetics, the relation of food, to blood sugar levels and the medications altering the levels is quite complex. Dr Shanawaz Mir, renowned endocrinologist working at GMC Srinagar said it was best for diabetics to consult the healthcare provider before fiddling with medication doses. He said each case and case history is different but added that fasting safely for diabetics was “quite possible with planning.”

Dr Mir said individuals taking a class of drugs called sulfonylureas, meglinides or insulin may need dose adjustment to avoid hypoglycemia while fasting. These medications would need dose adjustment. “Usually we put the person on half the dose at Sehri and full dose at Iftaar,” he said. In addition, he said, insulin dose adjustments must also be talked to with the doctor. “Most importantly, Dr Mir said, it was mandatory to keep checking blood sugar levels before and after fasting, and many times during day. “If the blood sugar levels fall below 70, immediately break the fast,” he said.

Dr Mir also emphasized the importance of breaking the fast with balanced meal that includes complex carbohydrates, proteins and healthy fats to prevent sudden spike in blood sugar.