Diabetes and fasting Ramadan
There are two types of diabetics who should break their fast and not fast during the month of Ramadan:
1- A very high-risk group, they include:
Patients who experienced severe hypoglycemia in the last three months
• A very high level of sugar, with the presence of acetone in the urine without a clear reason
• Constant exposure to episodes of hypoglycemia
• The absence of symptoms of hypoglycemia when the patient is exposed to it
• Not controlling sugar in IDDM
• Pregnancy in the presence of sugar or pregnancy sugar and the need for insulin
• Dialysis or kidney disease type 4, 5
• The presence of complications of DM at the level of blood vessels - advanced age and poor health.
2- A group of high risk, they are:
• Type 2 DM is not controlled
• The well controlled Type 1
• - pregnancy with DM or Gestational DM and the patient is living on tablets
• Chronic kidney disease stage 3
• The presence of stable vascular complications
• Diabetics who perform heavy manual work ...
These two types of patients mentioned above should not fast Ramadan, because fasting represents a grave risk to their lives.
The remaining patients , can fast, but it is necessary to be seen by his specialist doctor to review the doses of different medicines and insulin and adjust the dose according to the case. Also, diabetics, especially those who take insulin, should analyze blood sugar (when awaking in the morning – mid noon - two hours before Alfotor – just before Alfotor - two hours after Alfotor). If the fasting sugar is less than (70) or is more than (300), you should break the fasting immediately. As for the sugar, if it is between (70: 90), the doses of the medications should be set by reducing - and if the sugar is between (90: 126) then the sugar is controlled - but if blood sugar is more than (126), see a doctor to increase the dose of medications
Asthma and nebulizer patients
It is advisable to take long-acting nebulizers between Alfotor and suhoor. In the case of resorting to fast sprays during fasting and when there is a need for them. There are two opinions regarding this issue: - The opinion of the Egyptian Fatwa House believes that the sprays are invalid and should break fasting- and the opinion of the Saudi Fatwa House considers that they are not breaking the fast.
Heart and diabetes patients
Fasting is not permitted for coronary artery patients and for whom stents have been fitted or open-heart operations during the first six months after that, After first 6 months,if the condition is stable, he can fast. If it is not stable, he should break his fast.
- Breaking fasting should be done in all acute cases such as acute kidney failure - acute heart failure. very high blood pressure and angina cases - and arrhythmias.
Kidney patients with Ramadan
Kidney stones patient
He can fast, but must drink large quantities of fluids between Iftar and Suhoor, while adjusting the types of eating according to the type of gravel.
A chronic third, fourth or fifth type kidney patient may break the fast if he suffers from other diseases such as diabetes, hypertension, or heart disease because fasting in this case negatively affects kidney function.
Do patients with advanced condition fast kidney failure (creatinine level more than 300 micromole or 3.5 mg), the kidneys are unable to keep fluids and salts during fasting, which leads to dryness and deterioration in kidney function?
It is not permissible to fast because of the harm that is done to the body, the perpetrator is guilty and obliged him to feed every poor person on a daily basis.
Is it better for patients with kidney failure fasting or not to fast?
It is better for the patient to break fasting because fasting can increase general weakness and fatigue in patients with kidney failure,specially, many of whom suffer from weakness in their bodies. Therefore, the patient is advised to break their fast and to feed each poor day if it is not possible to recover.
A kidney patient who relies on hemodialysis may break fasting , especially if there are other diseases associated with kidney failure.
A patient with kidney failure during a hemodialysis session takes solutions that contain sugar and salts and they easily reach the body through the blood. If the date of the session was during the day in Ramadan, does that invalidate his fast?
Yes, it invalidates the fast, so patients who wish to fast are advised to perform hemodialysis in the evening period, if possible, but if the patient insists on fasting, he must compensate for those days of breaking fasting or feed if he cannot make up and his recovery is hopeless for the days when he performed hemodialysis.
Is peritoneal dialysis during the day in Ramadan invalidate the fast?
Yes, PD invalidates the fasting The same provisions for hemodialysis, knowing that leaving a quantity of peritoneal washing fluid in the abdominal cavity before the time of sohor and to be contained in the perotineal cavity during fasing hours does not break fasting, as well as removing peritoneal fluids during the day does not invalidate fasting
Fasting and kidney transplant patients:
Clinically, kidney transplant patients are advised not to fast in the first year until kidney function is stabilized because during first year post transplantation, kidney function is unstable and doses of immunosuppressive medications are still high. After the first year:,If the kidney function is stable, he can fast but If kidney functions are not stable then he can break his fasting.
But you should consult your doctor about the ability to fast or not, as the decision depends on the medical evaluation for each patient separately
What medical advice with fasting for a kidney patient?
1- Ask your doctor if your health condition allows you to fast before entering the holy month.
2- Inquire about how to arrange medicines during Ramadan.
3- Make sure to delay suhoor meal.
4- Replace your body with enough fluid before Sohor without wasting as directed by your physician.
5- Take medications regularly.
6- Avoid excessive eating of foods such as meat and sweets.
7 - Avoid excessive foods rich in potassium, such as dates,, raisins and juices.
8 - Do not complete the fast and take the license to break the fast if you feel tired and tired during fasting and do not carry yourself more than its energy.