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Dear all, Assalamoalaykum. Hope everyone is fine. This post is for those patients who have diabetes mellitus and they want to hold fasts in coming Ramadan. As you all know that the eating and drinking pattern is reversed in Ramadan; i.e. we fast the whole day while are allowed to take meal and water after Aftari time till Sehri. Those diabetic patients who want to fast, must make sure that their sugar is under control before Ramadan and the doses of Insulin and oral drugs have been determined for that control of diabetes.
Those patients who are taking twice a day Insulin, as the eating pattern is reversed (as mentioned above), they must switch lower dose in the Sehri time and receive higher dose at Aftari time. This is against the dose of Insulin that we administer in ususal days when we administer higher dose in the morning and lower dose in the evenoing time. By doing this the patient would not suffer hypoglycemia during fasting. Similarly, those diabetics who are taking Sulfonylurias (like Glibenclamide, Glimipride or Gliclazide) as oral hypoglycemic agents, must not receive them at Sehri time, rather, for the reasons enunciated above, they should be administered at Aftari time. While other groups of oral hypoglycemic agents (like Biguanides, DPP4 antagonists, Glitazones and Gliflozines; as they do not cause Hypoglycemia, can be administered at Sehri time. All diabetics must avoid taking Sweets like sugar, Gur, sweetened juices only. the rest of the foods, like Rice, all kinds of vegetables including Potatoes and all kinds of fruits can be taken in moderation.
If these advices are followed diligently, I hope diabetics can also hold fast in the month of blessed Ramadan.
Take care..Allah Hafiz.