Millions of Muslims are now getting ready for the coming holy month of Ramadan and planning to change their habits. To prepare for the change in our routine life, we must be aware of any health implications, specially for the people who are on medication or have any other medical conditions like diabetes.

Health issues during Ramadan also affect the elderly, the weak, women who are pregnant or nursing their babies. Being aware of the health issues and getting prepared appropriately will help you to make the best deal of the holy month. So you can spend it focusing on worship instead of dealing with health problems.

Medication

Along with food and drink, oral medication and some kinds of injections invalidate fasting of Ramadan. Therefore, it is important to discuss with your doctor about your medication to change the dosage schedule to accommodate your fasting during Ramadan. For example, taking the medicine before seheri and after iftar must be approved by the concerned doctor.

Diabetes

If you are a diabetic and want to fast, it is important to be assessed by your doctor to ensure physical fitness by controlling diabetes.

Most of the diabetic muslims have strong desire to fast during the month of Ramadan. If they cannot perform it due to diabetes, they have a valid exemption. Fasting during Ramadan of Muslim diabetic patients is not obliga-

tory, but this is a privilege to be allowed by their physicians.

Muslim scholars recommended that blood tests for glucose monitoring and taking insulin do not invalidate the fasting of Ramadan.

Diabetologists suggest that diabetic patients who take oral hypoglycemic drug once daily, should take the medicine immediately after iftar at a low dose. Patients who take oral medicine more than one time daily should reschedule the dosage in the morning and at night (of regular time) respectively to after iftar and 30 minutes before sehri.

Patients who take insulin, should adapt the dosage schedule of insulin prior to Ramadan after consulting with a

diabetologist. Usually long-acting basal insulin is safer and recommended during Ramadan fasting. It should be administered after iftar at a higher dose and at sehri time at a lower dose.

Other medication of diabetes should be continued as per the advice of physician.

Patients should be taught home glucose monitoring, checking urine for acetone, doing daily weights, calorie-controlled diabetic diet, need for sleep and normal exercise.

They should be able to take pulse, temperature, look for skin infection and notice changes in the sensorium (mental alertness). They should be on special alert for any sign of dehydration, and should seek medical help quickly

rather than wait for the next day.

Pregnancy

Pregnant and nursing women are exempted from fasting if they have any health concern of themselves or their children.

Advice should be sought from doctors who can evaluate any specific concern. The doctor could also assist pregnant women to plan their meals so that they receive adequate nutrition during non-fasting hours to avoid fatigue.

Expecting mothers also have to be particularly aware of their intake of fluid for the nourishment of their upcoming babies.

Diet

As we fast for most of the day, we should eat slow digesting foods so we have a consistent amount

of energy throughout the day.

Slow digesting foods last up to 8 hours, while fast-digesting foods last for only 3 to 4 hours. Slow-digesting foods are those containing grains and seeds like wheat, unpolished rice (called complex carbohydrates), barley, oats, millet, semolina, beans, lentils, whole meal flour. Fastburning foods are those containing sugar and white flour (called refined carbohydrates).

Foods that contain fibre include whole wheat, grains and seeds, vegetables like green beans, peas, spinach, and the leaves of beetroot (iron-rich), fruit with skin, dried fruit, especially dried apricots, figs, prunes and almonds.

The food should be balanced i.e. fruits, vegetables, protein e.g.

Meat, chicken, fish, carbohydrate e.g. Bread, cereal and dairy products.

Most of the fried foods are not so healthy and should be limited. They may cause indigestion, heart-burn and weight problems. Changing your habits Due to less intake of coffee or tea during working hours, who are habituated in caffeine may suffer from headache, dizziness or fatigue during the first week of Ramadan.

They can also experience the unpleasant effects of sudden caffeine withdrawal, which can also include irritability, nervousness, anxiety and nausea.

You can minimise or avoid these symptoms by drinking lighter brews and gradually reducing your caffeine intake by the month before Ramadan.

It is also recommended that you drink plenty of water as a substitute and exercise regularly. Quitting smoking

If you are a smoker, you can take the necessary steps to stop smoking this Ramadan. This will allow you to gain the full benefit of this holy month and will be an important step towards restoring your health.

The atmosphere surrounding Ramadan helps one to have more discipline and strive to be a better Muslim in all aspects of life. It is an ideal time to give up smoking once and for all.