Certain medical conditions can be compatible with observing Ramadan, provided individuals consult with their healthcare provider. According to Melissa Dominicé Dao, a physician at Geneva University Hospitals (Switzerland), available data suggests that fasting during Ramadan appears safe for patients with controlled hypertension, stable ischemic heart disease, or stable heart failure.
However, fasting should be discouraged for those with a recent heart attack, unstable angina, recent heart failure decompensation, or those on high doses of diuretics.
Individuals with diabetes – both type 1 and type 2 – face an increased risk of hypoglycemia, hyperglycemia, and ketoacidosis during Ramadan, as well as potential worsening of disease complications. The level of risk varies depending on disease control. For those with well-controlled type 2 diabetes, the risk is considered “low to moderate,” even as it becomes “high” if the diabetes is poorly controlled. With well-controlled type 1 diabetes, the risk is “high,” escalating to “very high” when the condition is poorly managed. In the latter case, the International Diabetes Federation (IDF) and the Diabetes and Ramadan International Alliance (DAR), validated by recognized Muslim religious authorities, state that “the patient should in no case practice the Ramadan fast.”
Careful blood glucose monitoring is crucial for minimizing these risks. Patients with diabetes who wish to observe the Ramadan fast are advised to consult with their doctor or a dietitian several weeks beforehand to receive personalized guidance. Treatment plans, particularly insulin regimens, may need adjustments during the fasting month. Regardless, patients must measure their blood sugar levels multiple times throughout the day. Maintaining adequate hydration – one liter of water after breaking the fast and one liter before dawn – and balancing meals with at least two servings are also essential.
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