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Fasting, feasting and managing diabetes

Diabetes-Education

Dr AK Jhingan, Consultant Diabetologist, Diabetes Education Research Foundation, New Delhi.

Festivals in India are mostly associated with fasts and feasts whether it is Navratras followed by Dussehra and Diwali or Ramzan followed by Id. Festivals include rituals which involve fasting, as well as visiting friends and relatives which involve feasts. Markets are filled with sweets, and other food items which are rich in fat, sugar and salt.  During this time, not only do we find an increase in newly detected cases of type2 diabetes and other life style disorders, but also worsening of sugar control of people with diabetes.

Diabetes-EducationEveryone over-indulges a little bit on special occasions. People with diabetes too can indulge and enjoy themselves but moderation is the key to enjoyment and managing diabetes. Here are five tips to enjoy this festival season in good health.

 

  1. Fasting and diabetes- Most religions exempt individuals from fasting if they are suffering from an illness. People diagnosed with diabetes fall into this category and are exempt from the fasting requirement, but they often resist accepting this concession. While some people with diabetes have successfully completed fasts, there are others in whom fasting has created adverse effects on their health.

It is essential for a person with diabetes to consult their doctor before undergoing a fast of any duration. Fasting must be forbidden in people who have uncontrolled diabetes, complications of diabetes like high blood pressure and angina, a history of diabetic ketoacidosis, any other inter-current infection, who have undergone any surgery or are pregnant. Even if a person has controlled diabetes, it is advisable for him/her to discuss the full medical history and take advice from the doctor. A few points must be considered:

  • Do not stop taking medication, however the dosing and timing of medication may need to change – this should be discussed with the diabetes healthcare team prior to fasting.
  • Be sure to check the glucose level regularly so medications can be adjusted as needed.
  • If a person with diabetes experiences symptoms of low blood sugar levels such as sweating, anxiety, shaking, weakness or confusion, then they should immediately break their fast with a sugary drink followed by foods rich in carbohydrates.
  • Whenever you are allowed to eat, make sure to have lots of vegetables, fruits pulses, beans and whole grain foods as these are slowly digested and help your blood glucose to rise more slowly too. Also remember to drink plenty of fluids. Make sure that any drinks you consume are low calorie and sugar free.
  • Maintain your daily activity and do not over-eat after the fast is broken and minimise eating sweet or fatty foods
  1. Feasting and diabetes- Moderation is the key to enjoying life.
  • You can make minor changes to recipes for tasty but “not so healthy” dishes, by changing the style of cooking to make them healthier without compromising on the taste. For instance instead of deep frying cutlets you can enjoy grilled cutlets.
  • Consult your doctor beforehand and learn about the food exchange system. This means that you can have sweets in your diet instead of your normal food. For instance, one piece of barfi instead of your evening tea and biscuits.
  • Although most sweets are rich in both sugar and fat as they are fried, there are few sweets which are healthier than their counterparts. Rasgullas, Rasmallai and sandesh come in this category.
  • It is essential to plan meals especially if you going to attend a feast. Have your snacks at regular timings but use less fat or oil. When you begin to fill your plate, start with the salads. Control your portion size. Avoid second helpings just because your friends and family members want you to eat more.
  1. Exercise in festival season- It is recommended for everyone, including people with diabetes, to continue their regular daily activity in every season
  • Several studies indicate that light to moderate regular exercise during fasting is harmless.
  • If festivity includes lots of activity like shopping, playing garba and dandiya, then do consider snacks at regular intervals for preventing hypo. Monitor your blood sugar closely.
  1. Drink wisely- It is always good to drink plenty of water and non-sugary drinks throughout the day to keep you well-hydrated. This also helps your blood glucose levels from becoming too high.
  • If you are in a festive mood and want to drink alcohol, (even though it’s not recommended & better avoided) remember men should drink no more than 3 units a day and women should drink no more than 2 units a day.1 unit of alcohol could be half a pint of normal strength beer (4%), a single 25ml measure of spirits or a 125ml glass of wine (9%).
  • Always take your drink along with your meal.
  1. Medication and Monitoring is essential- Monitor your blood glucose more frequently to see how well you’ve done and take action if needed. Never skip your medication. If you feel that the dosage and timing of your medication need to change, discuss with your doctor. If you are on insulin, you can learn from your doctor about insulin dose adjustment according to your meal.

Remember, festivals can be enjoyed only when you are in good health.

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