Ramadan fasting presents an extra challenge for Muslims with diabetes

Tens of thousands of Muslims in Calgary are starting a month of fasting as Ramadan gets underway.

ButMuslims with diabetes can find Ramadan and its religious obligations, includingdaily fasting, particularlydifficult to navigate.

They need to take extra care around medications, diet and controlling blood sugar levels.

But doctors say fasting, oneof the five pillars of Islam,is still possible for some people who haveType 2 diabetes.Some can easily fast, others can fast with caution, or not at all, according to Dr. Fauzia Moyeen but she said those with Type 1 diabetes can't even attempt to fast.

"We've been working continually for the last month increasing the awareness among communities and doctors and nurses,"said Moyeen, a diabetologistand international diabetes trainerwho developed the condition herself two years ago.

"Firstly, weneed to train people with diabetes to stay closely in contact with their physician, educators and pharmacists during Ramadan," said Moyeen.

Diabetes is a disease in which the body is not producing insulin,the hormone that controls glucose in the blood, or not properly usingthe insulin it can produce.

As well as problems with regulating blood sugar, overeating when breaking fast at the end of the day can also be a problem, being tempted by sweet treats and rich food, says Moyeen.

She says people with Type 2 diabetes who want to fast need to assess their risk before doing so, through their family doctor.

In Islam, children,elderly people, pregnant and breastfeeding women and people with illnesses are all exempt from fasting. But some still want to fast in some capacity.

Moyeensays altering expectations, like fasting forfewer days than everyone else and avoiding problemfoods, can make it possible.

"Those who still want to, we help them," said Moyeen. "They also need to have adiscussion with their physician."

Dr. Mukarram Zaidi, a family physician, says Muslims with diabetes should always contact their doctor before Ramadan to discuss a plan.

"In Islam, it's OK not to fast if your family physician tells youit's OK," said Zaidi.

Zaidi says Ramadan isn't about forcing people to fast.

"They need to get blood work done first and their doctor is the bestperson to tell them if they can fast," he said. "Also, seeing if their medications can be adjusted for Ramadan."

Zaidi says patients need to keep track of their calorificintake and avoid high glycemic index foods and items rich in sugars and deep fried foods, opting forslower-release carbohydrates, such aswholegrain bread and rice.

Ramadan runs through the month of April.