A survey conducted in 39 countries involving more than 38,000 Muslims reported that a median of 93 per cent fasted during Ramadan. In light of this, it is particularly important for Muslims with conditions such as diabetes and high blood pressure to eat balanced and healthy meals throughout the holy month.
Here’s where a new application comes into play: it allows individuals to choose their Ramadan food menu with a calorie count, customised to the cuisine of their choice, so that they can ensure they have a nutritious meal plan.
Healthcare professionals take action
A cornerstone of Ramadan diabetes management is patient education, and experts emphasised the crucial role of pre-Ramadan counseling by Health Care Personnel (HCP) to reduce health risks associated with fasting, backed by clinical evidence and research presented from various countries.
Facts and data were presented by experts at the DAR International Alliance congress in Dubai on Wednesday (May 24).
Dr Mohamed Hassanein, Chairman of Diabetes & Ramadan International Alliance, and Consultant in Endocrinology at Dubai Hospital, said: “This year, the consolidated review of our work was published in Elsevier’s Diabetes Research and Clinical Practice medical journal, a first of its kind article that provides evidence-based strategies to enhance the management of Diabetes during Ramadan. Our long term goal is to bring about a progressive behaviour change among fasting patients and communities.”
A large amount of research was presented to back up the guidelines published last year. Experts discussed the bio-chemical (cholesterol, kidney function, glucose control) and bio-metric (blood pressure and weight) changes that take place in the body during the Ramadan fasting period.
Studies demonstrated how there was no significant change in a patients’ overall health, with a marginal improvement in blood pressure, when diabetes is managed effectively. However, this information cannot be generalised, as some patients can improve in health, while others might get worse.
A high emphasis was placed on the importance of consulting a doctor, who can then work on an individual’s personal interest and medical history, and prescribe the best course of treatment and action.
Dramatic change in eating patterns
A study presented by Dr Fatheya Alawadi, Head of the Endocrine Department, Dubai Hospital on ‘Attitudes and behavior of people with Diabetes during Ramadan’, highlighted how patients benefited from proper pre-Ramadan education and counselling.
During Ramadan, there is a dramatic change in eating patterns compared with other months of the year. Dietary recommendations need to be individualised and tailored to patients’ lifestyle requirements, age and other medical needs.
This makes dietary advice critically important in the pre-Ramadan assessment.
Ramadan Nutrition Plan app
The DAR International Alliance has developed the Ramadan Nutrition Plan (RNP), a web-based tool designed to help HCPs in delivering patient-specific medical nutrition therapy (MNT) during Ramadan fasting.
Cultural and regional differences can make it challenging for HCPs to deliver individualised patient-applicable dietary advice. To assist in this regard, the RNP includes meal plans for different countries and in different languages. Meal plans are categorised in several daily caloric targets.
This may aid HCPs and patients to plan daily meals with the aim of maintaining body weight if they are lean, or reducing body weight if they are overweight or obese. The RNP has been adopted for use in many countries and it may allow patients with limited access to HCPs to construct a healthy eating plan for Ramadan.
Guidelines inadequate in Muslim-minority countries
Prof. Adel Al Sayed, Chair of the IDF MENA Region, said: “A lack of knowledge and awareness on safe fasting measures for diabetics mean advice and guidance provided by HCPs may be inadequate, especially in Muslim-minority countries. For example, in a survey of HCPs in the US, only one-third of physicians actively enquired whether their Muslim patients intended to fast during Ramadan, and many did not feel comfortable managing these patients.
“Embracing and utilising advances in technology may be one way to improve accessibility to information about management of diabetes during Ramadan, especially for people in remote regions.”
Dr Mohamed Hassanein added: “Patients from high risk groups include – Type I Diabetes patients, Type II patients on insulin therapy, pregnant woman with gestational diabetes and patients with kidney disease. People need to understand that they are not obligated to fast, if they are high risk patients. If they wish to fast, it is their responsibility to identify their own level of risk, and try to address all possible measures to minimise the risk in consultation with their physician.
“This includes – the choice of treatment, the timing of treatment, the dose during Ramadan, when to monitor blood glucose levels, frequency of monitoring, and most importantly, to accept the possibility of breaking the fast, as soon as the person notices that his or her glucose level is too low or too high, even if they do not feel the symptoms.”
Dr Abdulrazzak Al Madani, President, Emirates Diabetes Society said: “Key solutions to overcoming such barriers include raising awareness on issues surrounding diabetes, giving proper direction on religious tenets, and providing effective, socio-culturally sensitive patient education. Following a highly individualised management plan and close follow-up is an essential approach to avoid development of health complications among patients.”