Muslim residents of Jerusalem’s Old City prepare on Thursday for Ramadan, which begins today..
(photo credit: MARC ISRAEL SELLEM/THE JERUSALEM POST)
Muslims who have type 1 or type 2 diabetes and choose to fast on Ramadan despite not being obligated to, can cause themselves harm. Endocrinologist Dr. Zaina Adnan of the Zvulun clinic of Clalit Health Services in Kiryat Bialik near Haifa, wrote in a recent article in IMAJ (Israel Medical Association Journal) that such people should consult with a physician before fasting.
During the Muslim month of fasting, which is due to end on Sunda, all healthy Muslim adults are bound by their religion to abstain from food, drink and tobacco every day from sunrise to sunset. They eat two large daily meals during the month -- the Suhoor in the pre-dawn hours and the Iftar after sunset. While diabetics are not required to fast, many do it anyway, writes Adnan.
It is believed that for genetic and lifestyle reasons the prevalence of diabetes is significantly higher in the Israeli Arab population than in the general population (10.3% compared to 8.4%) making observance of Ramadan problematic for them. Diabetics who take insulin and/or drugs may develop hypoglycemia (low blood sugar) when fasting or hyperglycemia (high blood sugar) when gorging on food. Overindulging may also cause weight gain, which is harmful to such patients.
Other Ramadan health dangers to diabetics include thrombosis and dehydration. The elderly, those with weak kidneys and those with other chronic conditions listed in the article are at very high risk as a result of the fast, Adnan continues.
She urges diabetics who fast during Ramadan to be be evaluated by experienced physicians or diabetes nurses, before the month-long period, to examine whether they should be allowed to abstain from food and drink. If they can, they must get advice on what drugs, including injected insulin, to take and when.