Nutritionist and epidemiologist Ina Danquah, chairwoman of the working group “Diabetes and Migration” of the German Diabetes Society, gives the answers in an interview.

Question: How does fasting during Ramadan affect blood sugar levels and what does this mean for diabetics?

Ina Danquah: The problem is that during the fasting month of Ramadan, the rhythm of nutrition practically changes. We usually eat during the day and go to bed in the evening – so the body is starving while we sleep.

But in Ramadan, the last meal is taken before sunrise, and the first meal is taken after sunset. And you still need to sleep.

Because of this reverse rhythm, people with diabetes have to pay attention to many things: dosing medications correctly, even distributing them over time during the day. And of course: measure your blood sugar more often

Question: Diabetes is not diabetes, as can be seen from the difference between type 1 and type 2. From a medical point of view, for whom is fasting a greater risk and for whom is it a lesser risk?

Danquah: There are various working groups that have dealt with this issue, including the German Diabetes Society. They have issued recommendations for classifying people with diabetes into different risk groups. This depends, for example, on how long the diabetes has been present, what type it is and how high the risk of complications is.

Nutritionist and epidemiologist Ina Danquah is chair of the working group “Diabetes and Migration” of the German Diabetes Society.

© dpa / —/Ina Danquah/dpa

Let’s say we have a patient with type 1 diabetes whose condition is relatively poorly controlled. This means that his blood sugar levels are regularly high or low – medically known as hyperglycemia or hypoglycemia. Especially if complications have already occurred, then this person is at a very high risk. If he still wishes to fast, he should be well informed of the risks that fasting may entail and should be closely monitored.

Overall, if you have diabetes, it is important to consider fasting for Ramadan as early as possible and talk to your doctor about it. And also consult with other medical personnel, such as nutritionists or nutritionists. It is important that the other person has a basic understanding of this religious practice. So he or she needs to understand why it’s important to you, rather than trying to talk you out of it.

Question: What are the most important rules for diabetics fasting during Ramadan?

Danquah: For people with type 1 diabetes, it’s been helpful to have your blood sugar checked regularly, which means having a very close overview. So-called glucose monitoring systems can help with this. They provide real-time information via a sensor and can often be connected to apps, which then recommend how to respond.

These systems can often even be linked to insulin pumps. This automation greatly helps people with type 1 diabetes during Ramadan.

For people with type 2 diabetes, it makes sense to consult with a doctor in advance: how should drug treatment be adjusted in terms of timing and dosage? Because: If you don’t eat or drink at all during the day, the dosage of so-called oral antidiabetic drugs has to be reduced.

By the way, the same rules apply to food during Ramadan as to people with diabetes: it should be a healthy diet with complex carbohydrates, ideally of plant origin. This can prevent blood sugar levels from spiking.

But of course, the sugar festival at the end of Lent is the exact opposite of this. But then you, so to speak, return to a normal rhythm and can check with your doctor in advance: can I overdo it without any health consequences? Here too there are ways to correct this with the help of medications.
© German Press Agency

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