Diabetics, heart, blood pressure and kidney patients are among the groups in need of a special situation during Ramadan and their worship and obedience, especially since the blessed month falls for the second year in a row in light of the outbreak of the Corona pandemic.

Doctor Ayman Saqlali, spoke to Anadolu Agency, providing 10 valuable medical advice for patients with diabetes, stress and heart, in order to follow them during this period of fasting and worship, and to adhere to the preventive instructions against Corona.

He says, "High blood pressure is considered a high risk disease for people with Coronavirus, and there are a large number of them who have other diseases such as diabetes and heart disease."

"People with these diseases usually ask about the possibility of their fasting, given the special situation and the condition they suffer from, without there being any negative effects on them," he added.

And he added that fasting has many benefits and must be used appropriately so that it does not lead to harm.

Here are 10 tips this doctor gives:

General advice for diabetics:

  • Diabetics should consult their doctor before Ramadan, about whether or not to perform the obligatory fasting, as each patient has his own condition, and only the doctor is able to evaluate it, and fully adhere to the treatment plan prescribed by the doctor.

  • Avoid eating a large amount of food during breakfast, and divide it into several small meals between Iftar and Suhoor times, to avoid sudden changes in blood sugar level.

  • Avoid eating simple or fast-absorbing sugars (white sugar, sweets, some fruits, starches, and others).

  • Make sure to eat more vegetables that contain fiber (such as tomatoes, cucumbers, carrots, lettuce and spinach), which help to strengthen the body after long hours of fasting.

  • Drink enough water (about 2 liters a day) and focus on the elderly, as symptoms of dehydration appear on them more quickly than other age groups.

  • Take care to get regular physical activity, and walking is one of the most popular sports.

  • Make sure to eat the suhoor meal and eat protein during it, as opposed to avoiding sugars in this meal, to avoid a sudden rise in blood sugar that results in a concomitant rise in the hormone insulin, which could expose the patient to a decrease in blood sugar.

  • Daily blood sugar monitoring, especially those who use insulin, daily blood sugar monitoring is very important in determining the appropriate insulin dose, which avoids low or high blood sugar.

General rules for patients with heart disease and high blood pressure:

  • Reduce as much as possible the amount of salt in the food, so that it does not exceed 3 grams per day.

  • It is advised to multiply meals and reduce their quantity, to walk after breakfast and avoid physical exertion during fasting, and to drink enough water, and for patients with heart failure, it is determined by the attending physician.

Fasting after consulting a doctor

For his part, Professor Abdul Badi Abu Samra, Head of the Internal Medicine Department at HMC in Qatar, advises diabetics that they should consult the treating doctor before starting fasting in order to control the level of blood sugar and avoid any complications during the fasting period, as the decision of the attending physician is based on the fast Whether or not, according to the nature of the condition of type 1 diabetes patients dependent on insulin treatment, as well as diabetic pregnant women, we advise them not to fast in order to avoid serious complications.

As for type 2 patients who do not have heart complications and kidney complications, they can fast with some precautions, including: reviewing the treating doctor before the start of the month of Ramadan in sufficient time to regulate blood sugar levels, reviewing drug doses and organizing their times in proportion to the hours of fasting, and it is preferable to delay the pre-dawn meal as much as possible. Possibility, and drink plenty of water between the pre-dawn meals and breakfast to avoid dehydration.

For a safe fasting for diabetics, Professor Abu Samra affirms - in a press release that reached Al Jazeera Net - the need to maintain the sugar level within the patient’s safe rate of 80-180 milligrams / deciliter after breakfast, to commit to eating the suhoor and iftar meals, and to delay the suhoor as much as possible with greater eating. A measure of water between breakfast and the pre-dawn meal to protect the kidneys from dehydration and poor performance.

It should also reduce the consumption of stimulants such as tea, coffee and soft drinks, because they contain caffeine that causes diuretics, which exposes the fasting person to losing large quantities of fluids, in addition to postponing exercise until after breakfast to avoid episodes of hypoglycemia.

Going to the mosque is part of the daily permitted physical and sports activity for patients during Ramadan.

It is necessary to ensure that the blood sugar level is checked several times a day, especially the first days of fasting, as well as at any time when the patient feels low blood sugar, while avoiding sleeping in the last hours of fasting, and it is preferable to see a doctor or a diabetes educator several times during Ramadan. To make the necessary adjustments for diabetes medications or any other medications the patient is taking.

Fasting kidney patient

For his part, Dr. Hassan Al-Maliki, Senior Consultant and Head of the Department of Nephrology at HMC, classifies kidney patients who wish to fast during Ramadan into 3 sections according to the degree of disease in order to ensure their safety from complications.

Al-Maliki says: For patients with acute renal insufficiency, their health condition is critical, and they are prohibited from fasting until the kidneys condition improves and returns to normal. As for chronic kidney patients, their stages of nephropathy differ. Because the kidneys at this stage are unable to retain body fluids, which may cause severe failure in their functions, and this may lead to significant kidney damage, as well as fasting for a long period greatly decreases body fluids, and patients must refer to the treating physician to find out the extent of the injury Kidneys and the effect of fasting on them.

As for dialysis patients, Al-Maliki explains that they wash the blood 3 days a week, and thus they can fast for the rest of the days, as the washing process is accompanied by the administration of intravenous solutions, which spoil the fast.

As for patients with peritoneal dialysis (abdominal washing) that the patient himself does at home, they cannot fast due to the presence of nutrients in washing liquids.

Dr. Al-Maliki advises kidney transplant patients not to fast, due to the effect of the lack of fluids on the transplanted kidneys and the need to take medicines regularly and at specific times, as well as most kidney transplant patients have diabetes, and this increases the risk of fasting for the patient, so he must consult his physician on an ongoing basis.

Heart patients

As for heart patients, fasting has several benefits, according to Dr. Ammar Salam, Senior Consultant and Head of the Cardiology Department at Al Khor Hospital and Associate Professor of Clinical Medicine at the College of Medicine at Qatar University, as the incidence of various heart diseases such as heart attack (stroke), heart failure, and irregularity decreases. Heart failure (atrial fibrillation) in the month of Ramadan, and the incidence of heart failure and atrial fibrillation resulting from coronary artery failure decreases.

He explained that fasting during Ramadan also increases the level of beneficial cholesterol by 30-40%, which in turn protects the heart arteries from harmful cholesterol deposits.

Research has shown that fasting and the religious rituals that accompany it lead to calm and decreased excitability of the parasympathetic nervous system, leading to decreased pressure and heart rate, which are good medical signals for most heart patients.

Dr. Salam affirms that the treating physician should be consulted several weeks before the start of fasting, especially patients with severe arterial insufficiency, to adjust the dates of taking the drug and receive the necessary instructions to avoid any symptoms such as a headache during fasting, by reducing the consumption of tea, coffee and other drinks that contain caffeine before fasting. With 5 days, heartburn and heartburn can be avoided by not overeating, especially foods that contain high sugars and fatty substances during the month of Ramadan.

As for heart patients taking medicine during Ramadan, Dr. Salam indicates that the patient can take the medicine once at breakfast and again at dawn, and for those who take their medicine 3 times a day, they must see a specialist doctor to replace it with a long-acting medicine that is taken once or twice a day.