KEPALA BATAS: As Muslims enter the holy month of Ramadan, diabetics are carefully balancing faith and health – adjusting medication, monitoring blood sugar levels and moderating meals to fast safely.
For 69-year-old Faridah Abdul Rahim, discipline and close monitoring are key.
The housewife, who was diagnosed with diabetes eight years ago, said she has been able to fast without major issues.
“At sahur and at iftar, I take two types of medication. I drink plenty of water and control my food and drink intake.
“So far, everything is OK,” she said.
Although she eats most foods she enjoys, Faridah said she does so in moderation and never skips her medication.
Retired civil servant Abdul Aziz Omar, 78, has lived with diabetes for 20 years and knows he must be extra vigilant during Ramadan.
Although his condition does not stop him from fulfilling his obligation to fast – one of the main pillars of Islam – he is mindful of his blood sugar levels.
“I still fast as usual, but I reduce my food intake during buka puasa and only eat bread for sahur,” he said.
Abdul Aziz said his blood sugar levels are slightly better controlled during the fasting month, and he makes it a point to take his medication regularly.
“During Ramadan, the routine changes and can be a bit disrupted. However, I make sure I take all my prescribed medication,” he said.
He also takes traditional remedies and monitors his blood sugar regularly.
Universiti Sains Malaysia family medicine specialist Dr Mastura Mohd Sopian said elderly patients with diabetes can fast safely if they undergo risk assessment.
“Older people with well-controlled type 2 diabetes, stable medication regimens, good cognitive and functional status, and the ability to self-monitor blood glucose may be suitable to fast, provided precautions are taken,” she said.
However, she warned that fasting is not recommended for high-risk individuals, especially those with recurrent hypoglycaemia or hyperglycaemia unawareness, people requiring frequent insulin adjustments, patients with advanced kidney or heart disease and the frail or cognitively impaired.
“Those recently hospitalised for hyper- or hypoglycaemia, or with significantly poor glycaemic control or acute illness, are also considered high-risk,” she said.
Dr Mastura said monitoring blood sugar at key times – before sahur, mid-morning, mid-afternoon, pre-iftar and about two hours post-iftar – is essential to reduce complications.
She stressed the importance of a pre-Ramadan assessment, including frailty screening, medication review as well as functional and cognitive evaluations.
She added that patients should maintain adequate hydration, avoid skipping sahur and break their fast immediately if they experience symptoms of hypo- or hyperglycaemia.
