My wife is pregnant, and she is diabetic? What are the chances of the born child being diabetic as well?
Is there any danger on the baby or her health if she is fasting in Ramadan?
Thank you Doctor
Answer
First of all, the probability for the baby to be diabetic due to a diabetic mother is usually between 3-6%
So the probability for a single baby is usually low.
The second part is the pregnant mother, whether diabetic or not, has the right to not fast during Ramadan to protect her health.
The pregnant mother who IS diabetic, espicially if she depends on insulin, is not recommended to fast because this would make her susceptable to high increase in acetone in the blood and low sugar concentration in the blood.
That is why we do not recommend her to fast.
But if the mother is not insulin-dependent, or has a very light diabetic problem, then there's no problem for her to fast.
Name
ola
- Egypt
Profession
Question
how we can diffrentiate between a hyperglycimic and hypoglycimic coma and I want to know the first aid for both if they happened during the fasting days in Ramadan ?
Answer
In both cases, the patient will feel similiar symptoms such as not being able to concentrate.
In hypoglycemia, the patient will feel increased sweating, hunger, and dizziness. They will feel they have no energy and lack of concentration.
If they takes any sugary drinks, they will feel they are getting better quickly.
In the hyperglycimic coma, it increases slowly and they will feel they cannot concentrate, dry mouth, and alot of sweating.
For this patient, drinking sugary drinks will not help.
For first aid, sugar concentration in blood must be diagnosed to determine what type of coma they had. Acetone can also be detected in the urine of patients with hyperglycemia.
Hypoglycemia can usually occur if the patient took a higher than normal dose of insulin or took their normal dose but made vigorous exercise.
For a fasting patient, there's another point to be taken in concentration. If the patient is fasting and didn't eat suhur, this could form acetone so differentiating between the two types of coma can be more tricky. This can be resolved by having a urine test, if there is no sugar and there is acetone then this is a hypoglycemia. Otherwise the coma is a hyperglycemic coma.
Name
Aisha
-
Profession
Question
My Mom is 46 Diabetes and she needs a simple diet plan for Ramadan and what are the healthy habits especially when it comes to Iftar? thank you
Answer
First, a good diet for Ramadan would be one in which carbohydrates are between 50-60%, proteins 20-30%, and fats are less than 15%
She should try to reduce fats, and try to go for oils which are unsaturated lipids. The best oils are of course cottonseed oil and linseed oil.
Regarding carbohydrates, she should eat more starch then sugars.
As for healthy habits, an important one is not to spend all time between Iftar and Suhur eating. She should eat her main meal, the one at Iftar, then she can have a light snack around 12:00 at midnight and finally Suhur with her medication late at night.
If she is taking 2 insulin doses, then she should take around 2/3 of her total dose during Iftar, and 1/3 around 12:00 midnight. She should then take her Suhur without an insulin dose.
This arrangement is done so that if she enters into a hypoglcemia attack between 12:00 and Suhur, she can quickly eat and fix her blood sugar level. If she takes her dose at Suhur and she enters hypoglycemia then she must eat the following day and not fast.
And we mentioned before that insulin dependant patients have the right given to them by Allah not to fast.
Name
Zaheera
- Morocco
Profession
Question
What kind of precautions should a diabetic person follow during the month of Ramadan? From both food side and activity side?
Answer
The precautions are they don't increase the sugars in their food too much so they don't go into hyperglycemia.
And also not to go into too much activity so they don't go into hypoglycemia.
This is espicially for people in countries who fast long hours.
So for people who work at jobs demanding alot of activity, they should try to make their jobs after Iftar.
These precautions are also applied to non-diabetics as well.
Name
Zeinab
- Morocco
Profession
Question
What are the ideal things to eat in both Iftar and Suhur?
Answer
For a diabetic person, we have mentioned before a good diet in which the patient doesn't eat too much sugars.
In countries with hot weather, the patient can also drink a small glass of juice, maybe some compote, but also not too sugary to protect against hyperglycemia.
As for Suhur, we need something that is high in carbohydrates that are slowly digested in the body. So a glass of juice is not good because it might cause a sudden increase in sugar.
That is why the patient should take more carbohydrates and less sugars.
So for Iftar, they should eat more sugars to compensate the body for all the time fasting.
But for Suhur, they should eat more carbohydrates and less sugar. Beans are good because they have delayed absorption and can maintain the body for nearly half the day at a good level, by the time it will decrease the time for Iftar would have almost arrived and hopefully the patient won't go into hypoglycemia.
During the time between Iftar and Suhur, the patient should drink alot of water.
Name
Tamer
- Egypt
Profession
Question
I have Diabetes Type II and I usually feel out of energy and tired while fasting. What should I do to not feel like that?
Answer
First of all when you get this feeling you might have low blood sugar level.
If upon measuring sugar blood level it is low, then you should try to increase the amount of food you eat during Suhur or decrease the concentration of medication you take at Suhur but only after consulting your doctor. This is done so you can maintain a good sugar level during the day.
But if when you feel this way you are not hypoglycemic, and your blood sugar level is fine, then try to ignore it. It could be due to less sleep or anxiety or more work...any reason not related to diabetes.
Name
Inam
-
Profession
Question
Assalam o alaikum. my mother is diabetic, aged 70. she is on insulin,morning and evening.is she allowed not to fast.what fidya should we offer instead of her fasting
Answer
At 70 years old, she has the right from Allah not to fast. And patients taking insulin also have a right not to fast given by Allah.
It is up to her now to fast or not, if she can do it or not.
But as for the religion side of your question I cannot help with it.
Editor Note: Please refer with your question to the Shariaa' department who can refer it to one of the esteemed scholars
Name
Melanie
-
Profession
Question
Doctor
What kind of precautions should people understand and carry out in order to avoid being susceptible to diabetes
Thank you
Answer
One of the most important factors that make a person liabable to diabetes is genetic tendency. This can be aggravated by gaining alot of weight, eating alot of sugars, severe lack of exercise, being a smoker, or if they are often stressed.
Try never to leave an infection uncontrolled since it can unmask a hidden diabetes.
Name
Sophie
- France
Profession
telesales
Question
Fasting now in Paris are for very long ours? Can a diabetic person endure these long ours without fear of any problems?
Answer
Usually for Diabetes Type I, it is hard to tolerate such long hours. They should not fast. As a matter of fact, there are people that think it is a crime for a doctor to let a Type I patient fast for long hours.
As for Type II, especially in overweight patients, they can tolerate it as long as they are not insulin dependent.
As a matter of fact fasting is good for overweight patients so they can lose some weight!
Name
Khalid
-
Profession
Question
What are the severe effects caused on the body if diabetes remained uncontrolled ?
Thank You
Answer
Of course if diabetes is uncontrolled then there are the secondary complications. These do not leave a single system unaffected.
This starts with the cardiovascular system, this is the one most severly hit. Ranging from hypertension to nephropathy (damange to the kidneys) to retenopathy (damage in the eyes) which are affected due to damage to the microvessels of the blood. This can lead to kidney failure in case of nephropathy and blindess in case of retenopathy.
Then there is also vascular insufficency which might cause gangrene. There's also infections that lead to diabetic foot and can end with amputations.
Diabetic foot is a severe case because it is an infection requiring very strong antibiotics for very long times. This means the patients cannot go to work, they might need hospitalization, surgery, and expensive antibiotics.
This makes a patient with diabetic foot a burden on their family, their community and even their country since they cannot work and need expensive medications.
Name
Sophie
- France
Profession
Question
Thank you for response doctor.
Could you please explain how is it good for a diabetic person to lose weight?
Actually the connection between weight and diabetes?
Answer
There is a condition called Metabloic Syndrome. This condition encompasses many problems, but the most important are hyperinsulinimia (a result of insulin resistance),obesity and hyperglycemia. There are other factors but we don't need to go into them now.
Obesity makes the fat cells larger than normal. But the receptors on the cell do not increase, the number stays the same. The increase in size also makes the receptors distorted. This makes the receptor-insulin reaction at a level far below the optimum.
This means that, unlike Type I who have a lack of insulin, these people have MORE insulin than normal, but are still hyperglycemic. This is due to the inability of the cells to react with the insulin hormone, so rendering it ineffective. The pancrease keeps excreting more insulin to try to compensate, but the extra insulin still has no effect, which leads to the incease in insulin in the blood (insulinameia) with no decrease in sugar blood level.
This also puts an extra burden on the pancreas since it has to work extra hard to release more insulin.
If this patient takes no medication but loses weight then their insulin will decrease and the cells will be able to react with the insulin normally. Soon they will be back to normal.
That is why we always say that ladies who are obese should lose weight since they are in danger of diabetes. And we should also make sure our little children are not overweight to prevent them from entering this endless circle.
Once the patient loses weight, they will be able to deal with insulin normally again and won't need special treatment, or at least will be able to reduce the amount of insulin they need injected.
Name
Abla
- Egypt
Profession
Question
Can type one diabetes tolerate fasting not for long ours like in egypt?
Does the insulin dose need adjustments?
Answer
If the hours are not too long then it is still not recommended for Type I patients who takes insulin in high doses to fast. This can lead to vast variations in blood sugar level which can cause harm.
The patient can try to fast for one week and take periodical measurments of blood sugar level. If it's uncontrolled then they should stop fasting. If the sugar level in the blood is still controlled then they can continue fasting.
Name
maya
-
Profession
Question
What are the danger signs that when the diabetic patient notices on himself should stop fast immidiately?
Answer
If the patient feels that they are entering into a hypoglycemic coma or if they feel a taste of acetone in the mouth. The patient can usually feel when a coma is coming by experience.
In these cases they should stop fasting immidiately and eat something sugary quickly to compensate the low blood sugar level.
Otherwise they can continue fasting normally.
Name
Melanie
-
Profession
Question
Thank You doctor for your answer
Could you please explain to me more about how uncontolled infection could unmask diabetes?
Thank you
Answer
Uncontrolled infections increase the metabolism of the body due to fever so the body needs more insulin secreted.
Normally the body is able to increase the secretion of insulin to compensate for the increased need.
However, if the insulin secretion is borderline, that means that the body is already secreting the maximum amount of insulin it can, then it may enter into a hyperglycemia, so exposing diabetes.
Name
Sophie
- France
Profession
Question
Thank you doctor for a very detailed and simple answer.
Allow me one more question?
Can Diabetes in it's first stages be controlled by diet only without medications?
Answer
That is possible in Type II since the reduction of weight, coupled with decreased sugar intake can fix the sugar blood level in the body.
So before the failure of the pancreas in the late stages of diabetes, it is very possible to control a Type II diabetic patient on a controlled diet and exercise only without resorting to medication.
However, in cases of Type I, this can be very hard.
In Diabetes Type I, the pancreas does NOT secrete insulin in the first place or secretes very small amounts, so even if the patient controls their diet, there is still no insulin to control the little amounts of sugar and fat the patient eats in normal meals.
In Type I a controlled diet will help decrease the amount of insulin taken, but it will not be enough to control blood sugar level alone.
Name
Host
-
Profession
Answer
Thank you Dr. Fatma Hamad for this interesting session.
We apologize to our readers for the questions we could not answer due to time constraints.
