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Monday, March 27, 2023

Doctors: Fasting for diabetics, heart and kidney patients depends on the doctor’s assessment of the patient’s health condition



With the beginning of the holy month of Ramadan, people with chronic diseases, such as: "Diabetes, kidneys and heart"Many questions about their ability to fast, as consultant doctors from Hamad Medical Corporation confirm that determining the patient’s suitability for fasting or breaking the fast depends on the assessment of the patient’s health condition by the attending physician. In this context, Professor Abdel-Badih Abu Samra, Chief Quality Officer at Hamad Medical Corporation and Deputy Chief Medical Officer, advises diabetic patients to consult the attending physician before starting fasting in order to control the level of sugar in the blood and to avoid any complications during the fasting period, as the decision of the attending physician depends. Fasting or not, according to the nature of the diabetic patient’s condition. Professor Abu Samra told Qatar News Agency (QNA) that patients with type 1 diabetes whose treatment depends on insulin, as well as pregnant women with diabetes, advise them not to fast in order to avoid serious complications. As for patients with type 2 diabetes who do not have heart or kidney complications, they can fast. While taking some precautions, including reviewing the treating doctor before the beginning of Ramadan, in sufficient time to regulate blood sugar levels, review medication doses, and organize their times in proportion to the hours of fasting. For safe fasting for diabetics, Prof. Abu Samra stresses the need to maintain the sugar level within the safe rate for the sick person from 80-180 mg/dl after breakfast, commit to eating the pre-dawn meal and the pre-dawn meal, and delay the pre-dawn meal as much as possible while drinking the largest amount of water between the two meals. Iftar and suhoor to protect the kidneys from exposure to dehydration and poor performance, and it is also necessary to reduce the intake of stimulants such as tea, coffee and soft drinks, because they contain caffeine that is a diuretic, which exposes the fasting person to loss of large amounts of fluids, in addition to postponing exercise after Iftar to avoid episodes of low blood sugar. Also, going to the mosque is part of the daily physical and sports activity allowed for patients during the month of Ramadan. It is necessary to ensure that the blood sugar level is checked several times a day, especially in the first days of fasting, as well as at any time when the patient feels a low blood sugar rate, while avoiding sleeping in the last hours of fasting. It is also preferable to see a doctor or diabetes educator several times. During the month of Ramadan to make the necessary adjustments in diabetes medications or any other medications taken by the patient. As for kidney patients, Dr. Hassan Al-Maliki, senior consultant and head of the Department of Nephrology at Hamad Medical Corporation, classifies kidney patients who wish to fast Ramadan into three sections according to the degree of the disease, in order to ensure their safety from complications. Dr. Al-Maliki said, in a similar statement to the Qatari Sons Agency (QNA), that with regard to patients with acute renal failure, their health condition is critical, and they are prohibited from fasting until the condition of the kidneys improves and returns to normal. As for chronic kidney patients, the stages of their kidney disease differ, and it is advised Patients with kidney disease of the third degree and above not to fast, 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 severe kidney damage, and also fasting for a long period decreases body fluids In a large way, patients must refer to the attending physician to find out the extent of the kidney injury and the effect of fasting on it. As for dialysis patients, he explains that hemodialysis patients do blood dialysis three days a week, and therefore they can fast on the rest of the days, as the dialysis process is accompanied by giving intravenous solutions, which invalidates the fast.. As for peritoneal dialysis patients (abdominal dialysis), which The patient does it himself at home, so they cannot fast because there are nutrients in the washing liquids. Kidney transplant patients are advised not to fast due to the effect of lack of fluids on the transplanted kidneys and the need to take medications regularly and at specific times. Also, most transplant patients have diabetes, and this increases the risk of fasting for the patient, so he must consult his attending physician on an ongoing basis. Regarding the ability of heart patients to fast, Dr. Ammar Salam, Senior Consultant and Head of Cardiology Department at Al Khor Hospital, and Associate Professor of Clinical Medicine at the College of Medicine at Qatar University, confirms that the incidence of various heart diseases such as heart attack (stroke), heart failure, and irregular heart (Atrial fibrillation) decreases in the month of Ramadan, and the percentage of heart failure and atrial fibrillation resulting from coronary artery insufficiency decreases, and fasting in Ramadan also leads to an increase in the level of beneficial cholesterol by 30-40 percent, which in turn protects the heart arteries from deposits. harmful cholesterol. Research has proven that fasting and the accompanying religious rituals lead to calmness of the soul and a decrease in the excitability of the parasympathetic nervous system, which leads to a decrease in pressure and heart rate, which are good medical signs for most heart patients. Dr. Ammar Salam told Qatar News Agency (QNA) that the attending physician should be consulted several weeks before the start of fasting, especially for patients with acute arterial insufficiency, to set the dates for taking the medication and receive the necessary instructions to avoid any symptoms such as a headache during fasting, by reducing the intake of Tea, coffee and other drinks that contain caffeine five days before fasting. Heartburn and heartburn can also be avoided by not overeating foods, especially those that contain high sugars and fatty substances, during the month of Ramadan. With regard to heart patients taking medication during Ramadan, Dr. Ammar Salam indicates that the patient can take the drug once at breakfast and again at suhoor, and for patients who take their medication three times a day, they should consult a specialist doctor to replace it with a long-acting medication that is taken once or twice a day.

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