Fasting, feasting and managing diabetes
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.
1. Fastingand diabetes-Most religions exempt individuals from fasting if they aresuffering from an illness. People diagnosed with diabetes fall into thiscategory and are exempt from the fasting requirement, but they often resistaccepting this concession. While some people with diabetes have successfullycompleted fasts, there are other sin whom fasting has created adverse effectson their health.
It isessential for a person with diabetes to consult their doctor before undergoinga fast of any duration.Fasting must be forbidden in people who haveuncontrolled diabetes, complications of diabetes like high blood pressure andangina, a history of diabeticketoacidosis, any other inter-current infection,who have undergone any surgeryor are pregnant. Even if a person has controlleddiabetes, it is advisable forhim/her to discuss the full medical history andtake advice from the doctor. A few points must be considered:
Do not stoptaking medication, however the dosing and timing of medication may need tochange – this should be discussed with the diabetes healthcare team prior tofasting.
Be sure to check the glucose levelregularly so medications can be adjusted as needed.
If a personwith diabetes experiences symptoms of low blood sugar levels such as sweating,anxiety, shaking, weakness or confusion, then they should immediately break theirfast with a sugary drink followed by foods rich in carbohydrates.
Whenever youare allowed to eat, make sure to have lots of vegetables, fruits pulses, beansand whole grain foods as these are slowly digested and help your blood glucoseto rise more slowly too. Also remember to drink plenty of fluids. Make surethat any drinks you consume are low calorie and sugar free.
Maintainyour daily activity and do not over-eat after the fast is broken and minimiseeating sweet or fatty foods
2. Feastingand diabetes- Moderation is the key to enjoying life.You can make minor changesto recipes for tasty but “not so healthy” dishes, by changing the style ofcooking to make them healthier without compromising on the taste. For instanceinstead of deep frying cutlets you can enjoy grilled cutlets.
Consult yourdoctor beforehand and learn about the food exchange system. This means that youcan have sweets in your diet instead of your normal food. For instance, onepiece of barfi instead of your evening tea and biscuits.
Althoughmost sweets are rich in both sugar and fat as they are fried, there are fewsweets which are healthier than their counterparts. Rasgullas, Rasmallai andsandesh come in this category.
It isessential to plan meals especially if you going to attend a feast. Have yoursnacks at regular timings but use less fat or oil. When you begin to fill yourplate, start with the salads. Control your portion size. Avoid second helpingsjust because your friends and family members want you to eat more.
3. Exercisein festival season-Several studies indicate that light to moderate regularexercise during fasting is harmless.
If festivityincludes lots of activity like shopping, playing garba and dandiya, then doconsider snacks at regular intervals for preventing hypo. Monitor your bloodsugar closely.
4. Drinkwisely-If you are in a festive mood and want to drink alcohol, (even thoughit’s not recommended & better avoided) remember men should drink no morethan 3units a day and women should drink no more than 2 units a day.1 unit ofalcohol could be half a pint of normal strength beer (4%), a single 25mlmeasure of spirits or a 125ml glass of wine(9%).
Alwaystakeyour drink along with your meal.
5.Medication and Monitoring is essential- Monitor your blood glucose morefrequently to see how well you've done and take action if needed. Never skipyour medication. If you feel that the dosage and timing of your medication needto change, discuss with your doctor. If you are on insulin, you can learn fromyour doctor about insulin dose adjustment according to your meal.
Remember,festivals can be enjoyed only when you are in good health.
By- Dr AKJhingan,Consultant Diabetologist, Diabetes Education Research Foundation, NewDelhi.