Doctors to QNA: Fasting with Diabetes, Heart and Kidney Disease Depends on the Doctor’s Assessment of the Patient’s State of Health

Doha, March 23 (QNA) – With the beginning of the holy month of Ramadan, people with chronic diseases such as diabetes, kidney failure, and heart disease, have several questions about their ability to fast. Consultants from Hamad Medical Corporation (HMC) assert that determining the patient’s suitability for fasting depends on the assessment of the patient’s state of health by the attending physician.

In this framework, Chief Quality Officer, Deputy Chief Medical Officer at HMC Professor Abdul Badi Abou Samra, advises that patients should consult the attending physician before they start fasting in order to adjust the level of blood sugar and avoid any complications during the fasting period. The decision of the attending physician to fasting depends on the nature of the diabetes patient’s condition.

According to professor Abou Samra, to Qatar News Agency (QNA), type 1 diabetes patients dependent on insulin treatment as well as pregnant women with diabetes are advised not to fast in order to avoid serious complications. However, type 2 diabetes patients who do not have heart and kidney complications can fast with some precautions, including reviewing the attending physician well before the beginning of Ramadan to regulate blood sugar rates, reviewing the doses of the medication and regulating their times in proportion to the fasting hours. It is also preferable to delay Suhoor meal as much as possible, and to drink more water between Suhoor and Iftar to avoid dehydration.

Furthermore, In order to fast safely for diabetes patients, Professor Abou Samra stresses the need to maintain sugar levels within the patient’s safe rate of 80-180 mg/dl after breakfast, and to consistently eat Suhoor and Iftar meals, however delay Suhoor as much as possible while drinking as much water between iftar and Suhoor to protect the kidneys from exposure to drought and poor performance. Also, stimulants such as tea, coffee and soft drinks must also be reduced as they contain diuretic caffeine, which exposes those fasting to the loss of large amounts of liquids. In addition to postponing post-iftar exercise in order to avoid seizures of low blood sugar, and attending the mosque is also part of the daily physical and sporting activity allowed for patients during Ramadan.

It is necessary to ensure that blood sugar is checked several times a day, especially in the early days of fasting, as well as anytime the patient feels low blood sugar, even while avoiding sleep in the last hours of fasting, it is also preferable to see a doctor or diabetes intellectual several times during Ramadan to make the necessary adjustments in diabetes medications or any other medications taken by the patient.

For kidney patients,Senior Consultant and Head of HMCs Nephrology Department, Dr Hassan Al Malki, classifies kidney patients who wish to fast Ramadan into three categories according to the degree of illness in order to ensure their safety from complications.

Dr. Al Malki stated to Qatar News Agency (QNA), For acute renal deficiency patients, their health condition is critical. and they are prohibited from fasting until the kidney condition improves and returns to normal, Chronic kidney patients have different stages of nephropathy, and those with third-degree kidney disease and above are advised not to fast. This is because the kidneys at this stage are unable to retain body fluids kidney damage, which can cause severe deficiencies in their functions, and may cause significant kidney damage as well as prolonged fasting significantly decreases body fluids, patients should refer to the attending physician to see the extent of kidney injury and the impact of fasting on them.

Patients who are undergoing hemodialysis to treat kidney failure will typically receive the treatment three times a week and cannot fast due to IV fluid intake during the procedure; however, patients can normally fast during days they are not receiving hemodialysis.. As for peritoneal washing patients (abdominoplasty) performed by the patient himself at home, they cannot fast for the presence of substances fed with washing fluid.

Kidney transplant patients are advised not to fast due to the effect of low fluid on the transplanted kidneys and the need to take medication on a regular and timely basis, as well as the most diabetic transplant patients, which increases the risk of fasting on the patient, so he must consult his attending physician on an ongoing basis.

Regarding the ability of cardiac patients to fast, Senior Consultant Cardiologist and Head of the Cardiology Department at Al Khor Hospital and Associate Professor at Qatar University College of Medicine, Dr Amar Salam,asserts that the incidence of various heart diseases such as cardiac crisis (clot), cardiac failure, irregular heart (atrial tremor) decrease during Ramadan, cardiac failure and atrial trembling resulting from coronary artery failure are lower, and Ramadan fasting also increases beneficial cholesterol by 30-40 percent, which in turn protects heart arteries from LDL cholesterol deposits.

Research has shown that fasting and its accompanying religious rites lead to self tranquility and lowers excitement of the parasympathetic nervous system, resulting in lower pressure and heartbeat, which are good medical signals for most heart patients.

Dr. Amar Salam told Qatar News Agency (QNA), that the attending physician should be consulted several weeks before fasting begins, especially for patients with acute arterial deficiencies to adjust the dates of taking the medication and receive the necessary instructions to avoid any symptoms such as the sense of headache during fasting, By reducing your tea, coffee and other caffeinated drinks to five days before fasting special foods containing high sugars and fatty substances during the month of Ramadan.

For cardiac patients to take the drug during Ramadan, Dr. Amar Salam indicates that the patient can take the drug once again at iftar and again at Suhoor, and for patients who take their medication three times a day, they have to see the competent doctor to replace it with a long-acting medication taken once or twice a day. (QNA)