Diabetes and heart patients beware during Navratri fasts

[K K Aggarwal]

Diabetes and heart patients beware during Navratri fasts

Fast during Navratri for diabetic patients carries a risk of complications said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

Dr. Aggarwal released following facts about Navratri diet for patients with diabetes.

• Type 1 diabetes should not observe fast.
• Diabetic patients should not fast if their blood sugar level is below 60.
• Fast should also be broken if blood sugar is less than 70 in the first few hours after starting the fast.
• In type 2 diabetes, well–controlled with diet alone, the risk associated with fasting is low. However, there is a potential risk of post food high blood sugar if the patients overindulge in eating.
• Type 2 diabetic patients on diet control who also regularly exercise daily should modify their exercise program and not do it when they are fasting. They should do exercise only after 2 to 3 hours following the sunset meal.
• In diabetics with uncontrolled high blood sugar and high cholesterol, restriction of fluids intake during the day, can precipitate dehydration leading to paralysis and heart attack.
• Patients on metformin alone can fast as the possibility of low blood sugar is minimal. Two–thirds of the normal dose of metformin should be given immediately before post sunset meal and rest one–third can be given in the morning if they take a fruit-based breakfast. Similarly patients on pioglitazone can do fast without change in the dosage pattern.
• Diabetic patients who are on sulfonylurea drugs should talk to their doctors before fasting. Only glimepiride and gliclazide, which have also lower risk of low blood sugar can be given during fast but under medical supervision. Sometimes these drugs may be shifted to short acting drugs like repaglinide during the period of the past again under medical supervision.
• Patients who are taking insulin and taking only one meal a day may have to adjust the dose of their insulin and the requirement of insulin may reduce upto 40%.
• Most diabetic patients during fast will get control on a single dose of plain insulin before the major meal or longer acting at insulin at bed time.
• Patients on plain insulin should talk to their doctor whether they need to shift to lispro insulin instead of regular insulin to reduce chances of low blood sugar.
• Fasting diabetic patients who take heavy dinner may have to accordingly modify the dose of their insulin.
• The dose of high blood pressure drugs may need to be reduced up to 40% during Navratri fasts.