JEDDAH, 22 October 2005 — For healthy persons, fasting during the holy month of Ramadan can be very beneficial, but for people with chronic health problems or with medication regimens, physicians say fasting should be carefully monitored or it can turn deadly.
Patients who suffer from chronic diseases, including heart problems, hypertension, diabetes, ulcers, chronic renal failure or recent surgery should consult physicians before embarking on the month of fasting. Some may have to break fast in order to take medications.
Several studies found that Muslim patients during Ramadan modify the times of their prescription drug doses, the number of doses, time span between doses and total daily dosage.
“This often happens without seeking medical advice. These actions can modify the behavior of drugs in the body, resulting in treatment failures,” said Dr. Hassan Chamsi Pasha, consulting cardiologist at King Fahd Armed Forces Hospital in Jeddah.
“Doctors must be encouraged to monitor their Muslim patients with chronic diseases during Ramadan,” he added.
A survey of 81 patients regarding alteration of drug regimens during the fasting period of Ramadan found that 42 percent of the respondents adhered to their usual treatment; 58 percent changed their intake pattern.
Patients with chronic disorders must follow guidelines from their doctors in order to fast in Ramadan. Patients who must take their medications more than twice a day should avoid fasting. Others may take prescribed drugs at iftar or suhoor or both.
Some religious scholars allow necessary medications taken intravenously, by inhaler or suppository during fasting while oral medications are not allowed. If there is no alternative route for medications, the patient must break the fast.
Patients who should not fast include those who have undergone recent heart surgery, myocardial infarction or acute heart failure; patients with chronic renal failure may have an increase in serum potassium if they fasted, which may worsen their case.
Diabetic patients face various restrictions regarding fasting. For mild, stable, non-insulin dependent diabetes mellitus (IDDM), sometimes called Type Two, fasting will be ideally recommended for their treatment.
It’s a different story for Type One diabetes patients. Insulin is essential for survival and is the mainstay treatment.
“The Type One patients suffer sudden elevations and drops in the blood sugar (glucose) level due to relative insufficiencies of insulin,” said Dr. Mohamed Halawa of the Diabetes Department at Erfan Hospital in Jeddah.
A sudden hypoglycemia, which is a drop in the blood sugar level that causes dizziness, might affect these patients while fasting.
When patients take insulin injections before fasting, their blood sugar level becomes low. If they don’t eat to balance their blood sugar they are apt to get hypoglycemia. “It’s better for Type One patients not to fast,” Dr. Pasha said. “If they have hypoglycemia they should break their fast immediately.”
For the vast majority of people, fasting can be great for their health.
“Even though fasting is religious requirement, it has medical benefits too. For patients who are overweight or obese, Ramadan is a good chance for them to manage their weight,” said Dr. Pasha.
He added that fasting is also a rest for the digestive tract and for lowering lipids. Fasting is recommended for people who suffer from spastic colitis and some other intestinal disorders.
