Doctors are urging diabetics in Bahrain to go for a medical checkup before Ramadan to ensure they are fully aware of the facts about holy month fasting.
Fasting as a person with diabetes requires careful medical supervision and planning to avoid serious health risks like hypoglycemia (low blood sugar), hyperglycemia (high blood sugar), as well as dehydration.
They recommend that a trip to the doctor’s clinic should be carried out in advance of the holy month, allowing health care professionals, alongside patients, sufficient time to safely adjust meal plans and medications to reduce the risk of preventable complications.
Consultant family physician and diabetologist Dr Abeer Al Saweer highlighted that Ramadan is a deeply spiritual experience for many patients and any health risks need to be identified.
“In such cases, it is essential to develop an individualised care plan to minimise potential complications,” she said.
The advice came during a ‘Let’s Prepare for Ramadan’ conference held earlier this week at the Gulf Hotel Bahrain Convention and Spa in Adliya.
It was attended by Supreme Council of Health chairman and conference president Lieutenant General Dr Shaikh Mohammed bin Abdulla Al Khalifa, who stressed the importance of safe fasting.
“Risk stratification is a critical component of pre-Ramadan care for people with diabetes,” Dr Al Saweer explained, adding that patients need to be classified into different categories based on multiple factors.
The categories include fasting duration and climate, type and duration of diabetes and previous glycaemic control, plus individual factors such as age, gender, occupation, meal patterns and physical activity.
“Healthcare professionals managing high-risk individuals who insist on fasting are encouraged to quantify risk for each patient using a risk calculator,” she said, adding that this flexible tool considers multiple variables and enables physicians across specialties to better support patients who choose to fast.
Meanwhile, consultant family physician and diabetologist Dr Rabea Al Hajeri emphasised the importance of having a structured Ramadan nutrition plan for people living with diabetes, outlining a series of practical recommendations for patients.
“Pre Ramadan assessments should be carried well in advance, allowing healthcare professionals sufficient time to assess patients, adjust medications and provide dietary advice,” she said.
Dr Al Hajeri stressed that suhoor should be delayed as much as possible and should always be a balanced meal, incorporating complex carbohydrates, whole grains, adequate hydration, and fibre to prevent constipation and reduce glycaemic fluctuations.
“Iftar meals are often more than 1,500 calories, rich in sweets, sugary drinks, calorie-dense foods and desserts,” she explained. “These meals can cause sharp post-iftar glucose spikes and increase the risk of diabetes-related complications during Ramadan.”
The meals are frequently followed by continuous eating from iftar to suhoor. “Eating too quickly can further increase the risk of severe glycaemic excursions,” she added.
Dr Al Hajeri advised patients to drink sufficient amounts of water and sugar-free fluids, while limiting snacks to one or two servings of healthier options such as whole fruits, nuts or vegetables.
She also recommended breaking the fast with water and dates and encouraged healthier cooking methods, including grilling, boiling or baking.
To help maintain stable blood glucose levels, she noted that a balanced meal plate should consist of half non-starchy vegetables, one quarter carbohydrates, and one quarter protein.
Dr Al Hajeri also cautioned that some patients stop taking medications for conditions such as hypertension during the holy month, placing them at increased risk of serious complications, including stroke. “Physicians should actively counsel patients on the importance of continuing prescribed medications safely during fasting,” she said.
Comprehensive pre-Ramadan care should include nutritional planning, medication modification, patient education, weight management, encouragement of physical activity and regular glucose monitoring.
Although many people actually put on weight during the holy month despite daylight fasting, Dr Al Hajeri believes that Ramadan can be a good time to shed a few unwanted kilos through controlled eating, physical activity of one to two hours after iftar, and ongoing blood glucose monitoring.
The optimal weight-loss target is 0.5-1kg per week. Recommended daily caloric intake for weight maintenance is 1,800-2,200 kcal for men and 1,500-2,000 kcal for women taller than 150cm.
For weight reduction, men should aim for around 1,800 kcal per day, women taller than 150cm for 1,500 kcal per day, and women shorter than 150cm for 1,200 kcal per day.
She also encouraged the use of glucose sensors and monitoring tools to help patients identify foods that cause blood sugar spikes.
Currently, 537 million people worldwide are living with diabetes, and this number is projected to rise to 643m by 2030 and 783m by 2045. The Middle East and North Africa continues to have one of the highest diabetes rates globally.
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