Renowned diabetologist gives tips on whether diabetics can fast, who should not fast, what foods a diabetic can eat to break their fast, and much more.
(Representational image/Wikimedia Commons)
The auspicious Hindu festival of Navaratri is important not only to devotees but also for healthcare providers and patients when it comes to being cautious and following the correct food habits and diets during the nine-day fasting period.
Typically, all fasting periods during various religious festivals come with their own set of rules with respect to what type of food to consume — as in vegetarian in most Hindu festivals, or non-vegetarian in Muslim and other festivals.
With respect to Navaratri, there are rules on the duration of the fast as well as the type of food that can be consumed.
Commonly, the duration of the fast is approximately 12 hours — from sunrise (dawn) to sunset (dusk).
Diabetic patients can freely consume milk products, fresh fruit juice without added sugars, or whole fruits during the day.
They can end the fast with dishes like sabudana kheer or sabudana khichdi. (Sabudana is sago pearls, made from the milk of tapioca.) Skip onion and garlic during the nine-day period.
Another ingredient to avoid is processed salt: Use only rock salt while preparing food.
Avoid wheat flour, maida (refined flour), and rava (a durum-wheat product that is a form of semolina).
Talking to your doctor about your fasting plans could be of life-saving importance.
Many medicines like insulin and anti-diabetic tablets work for a minimum of three to six hours — like metformin — and a maximum of 36 hours, like tresiba.
So, changing the medicine after talking to the doctor according to one’s fasting plan will be the most informed decision any patient can make to keep themselves safe.
If the doctor advises against fasting during this festival, take their advice while you follow all other rituals — like not cutting your nails or avoiding smoking, drinking, or eating non-vegetarian food.
Do not put your body in a fasting state if you have diabetes and your doctor feels it is unsafe for your health.
Being aware of the complications that can occur during any fasting festival for diabetic patients is the most important part of making an informed decision before deciding to observe a fasting prayer.
It is also important to listen to doctors when they say that certain patients cannot observe or follow the nine-day fast as their medical condition could become severe or life-threatening, like DKA — diabetic ketoacidosis.
This condition is very dangerous and can lead to direct ICU admission if it occurs.
During fasting, our bodies produce a byproduct of fat metabolism called ketone. Ketones can increase the acid content of the blood, leading to a condition called diabetic ketoacidosis.
If you experience symptoms like fruity breath, shortness of breath, dark-coloured or frothy urine, low urine output, increased or intolerable hunger, increased thirst even after drinking a good amount of water, tiredness, weakness, or fatigue during a fast, please stop and contact your doctor immediately.
All of these symptoms are telltale signs of diabetic ketoacidosis, which needs to be treated only in the hospital with insulin.
Patients can be discharged with tablets if they recover quickly and get their blood sugar under control with tablets alone.
The most important life-saving tip to follow is to keep yourself hydrated.
Watch for signs and symptoms of diabetic ketoacidosis, stay in touch with your doctors, plan the medicine dosage and frequency a week before starting to fast, and do not hesitate to seek medical advice and consultation as soon as you feel uncomfortable.
Be prepared and keep yourself updated with knowledge about your medical conditions and medicine, and be alert regarding complications like diabetic ketoacidosis.
Following all of this will ensure that you complete your Navaratri fasting prayers without any medical problems or complications.
(The author is chief consultant diabetologist at Prashant Superspeciality Hospital at Velachery in Chennai.)
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