With Ramadan approaching, Hamad Medical Corporation (HMC) is urging patients with chronic medical conditions, such as diabetes and hypertension, to speak with their doctor before beginning a fast.
According to specialists from across the healthcare provider’s network of hospitals, it is imperative that patients seek professional advice before making any changes to their diet and medication regimes. Dr Amr Mohammed Elmoheen, Emergency Medicine Consultant at Hamad General Hospital, said that although patients who take daily medication can have this safely adjusted, changes made without a doctor’s advice can lead to serious complications. He urges patients with irritable bowel syndrome (IBS) and other chronic digestive and stomach conditions to take preventative measures by avoiding large meals, spices and fried and fatty foods, which may trigger symptoms.
Doctors and pharmacists work with patients to help prevent or minimise these effects. As an example, medications prescribed to be taken once or twice daily can normally be taken at Iftar or Suhoor, whereas medications that should be taken every six or eight hours may require a more complex solution that is best determined by a physician.’
Manal Musallam, Director of Diabetes Education at the National Diabetes Centre at Hamad General Hospital said that diabetics who chose to fast need to be aware of the potential health risks. She urges patients to talk with their doctors as early as possible before Ramadan begins.
Type 2 diabetics with poorly managed blood glucose levels, elderly patients with Type 1 or Type 2 diabetes who take insulin, pregnant women who take insulin, and breastfeeding mothers who have Type 1 or Type 2 diabetes are generally advised not to fast. Patients with long-term diabetes complications, such as kidney failure or heart disease, are also advised not to fast. Your doctor can help determine if it is possible for you to safely fast.
She said that it is important for patients with diabetes to monitor their blood glucose levels regularly and to drink adequate fluids during non-fasting hours. She recommends water over sugary beverages. She also advises that diabetics to ensure they eat the Suhoor meal and to avoid sleeping before Iftar as they may be at risk for hypoglycemia.
According to Dr Amar Salam, Senior Consultant Cardiologist and Head of the Cardiology Department at Al Khor Hospital, while it is necessary for heart patients to speak with their doctor before undertaking a fast, especially for patients who take medication, there is usually no negative effect for most cardiac patients.
While fasting is not recommended for some heart patients, including those who have recently had a heart attack or heart surgery, and patients who have narrowing or inflammation of the aortic valve, research indicates that fasting is good for the heart. Fasting not only lowers one’s risk for coronary artery disease and diabetes, but it can also cause significant changes in a person’s blood cholesterol levels, increasing HDL-C, the ‘good’ cholesterol by 30 to 40 percent. However, it is important for patients to consult with their doctor, especially patients who take medication and will require timing and dosage modifications, and potentially an alternative medication.’
Dr Salam also advised heart patients to eat small portions during meals and to avoid fatty, salty, and sugary foods and large quantities of beverages. He suggests patients who drink caffeinated beverages ease into Ramadan by reducing their consumption of tea, coffee, and other caffeinated beverages prior to Ramadan. He said that going without caffeine for long periods of time during Ramadan can cause withdrawal symptoms such as migraines and can be a shock to the system.
Dr Salwa Abuyaqoub, a Senior Consultant for Obstetrics and Gynecology at Women’s Hospital, stressed the importance of pregnant women speaking with their doctor before deciding to fast. She says that many pregnant women are able to safely fast, but there are exceptions. She said that while many pregnant women can safely fast, it is not medically advisable for women who have pregnancy complications such as diabetes and high blood pressure to fast.
If your doctor gives you permission to fast, take care to consume a healthy and balanced diet and drink sufficient amounts of water during non-fasting hours. Each year we see an increase in the number of pregnant women visiting our Emergency Departments during Ramadan because of dehydration.’
Patients unable to make it to their appointments or can see changes in their schedules because of Ramadan-related commitments, can call Nesma’ak at 16060 to re-book. For more information about the services available at the different facilities of HMC during Ramadan, visit hamad.qa.