Understanding people’s different cultural backgrounds, lifestyles and religious practices plays an important role in their healthcare, and this time of year is no different
The holy month of Ramadan, which sees Muslims all over the world fast during daylight hours, begins this weekend. Does having type 2diabetes exclude a person from fasting? Not necessarily. The decision belongs to the person, but getting some advice from health professionals can help.
Type 2 diabetes, which constitutes the majority of diabetes cases, occurs when the body becomes resistant to the actions of insulin, or loses the capacity to produce sufficient insulin from the pancreas. Insulin keeps the body’s blood glucose levels within a healthy range
People with type 2 diabetes can manage the condition by maintaining a healthy lifestyle, including doing exercise and keeping a healthy diet. In more serious cases, people with type 2 diabetes may need to take medications such as metformin, sulfonylureas, or other glucose-lowering tablets, or self-administer insulin injections.
Type 2 diabetes affects some ethnicities more than others. It’s more common in people of Middle Eastern, north African and south/south-east Asian backgrounds. Many Muslim Australians are from these ethnic backgrounds.
Using 2016 census data, and conservatively estimating an adult diabetes prevalence of 10 per cent among people of Muslim background (the exact prevalence is unknown), as many as 40,000 Muslims may be living with diabetes in Australia. And this number is likely to be increasing.
Dietary practices such as fasting, feasting, and consumption of special foods are an essential component of many religious and cultural celebrations.
For Muslims, fasting during the month of Ramadan is obligatory for all healthy adults, who must refrain from eating, drinking and taking oral medications between dawn and sunset.
During Ramadan, most people have two meals per day, at sunset and before sunrise. This can be risky for people with type 2 diabetes – particularly those who use insulin or certain oral diabetes medications – for a couple of reasons.
And conversely, the evening meal to break the fast, called “Iftar”, often involves eating large amounts of calorie-rich foods in a relatively short space of time. This can put people with diabetes at risk of high blood glucose levels overnight.
Omission or changes in the timing of medications may also contribute to instability of blood glucose levels.