People with diabetes must be cautious during Ramadan fasting: HCFI

Health Care, Heart Care Foundation of India, Medicine Comments Off

Precautions and consultation with physician are advised

New Delhi, 18th May 2019: India has the third-largest Muslim population according to statistics, and a majority of them will be fasting during Ramadan. This number will also constitute people living with diabetes and thus, the need of the hour is to fast while exercising caution. Fasting can bring about metabolic changes and they must adjust their diet plan during Ramadan.

There is a 12- to 15-hour gap in between meals which can become a problem for those with diabetes. It is therefore advised that they consume regular and timely meals. People with Type 1 diabetes are at a higher risk compared to those with type 2 when fasting during the holy month.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Ramadan this year will continue till the month of June and the fasting period will be longer due to daylight hours. It is imperative that people living with diabetes consult their doctor and monitor blood glucose levels regularly. People with type 1 diabetes and a history of recurrent hypoglycemia have a higher risk during fasting. In those with Type 2 diabetes, there is a likelihood of hypo- and hyperglycemia. A patient’s decision to fast should be made after ample discussion with his or her physician concerning the risks involved. Patients who insist on fasting should undergo pre-Ramadan assessment and receive appropriate education and instructions related to physical activity, meal planning, glucose monitoring, and dosage and timing of medications. The management plan must be highly individualized. Close follow-up is essential to reduce the risk for development of complications.

Some symptoms to be noted include fluctuating blood sugar levels, seizures and unconsciousness; blurry vision, headache, sweating, increased fatigue, and thirst. In case any of these persist, the patient should do away with fasting completely.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Thirty days of Ramadan in Islam; nine days of Navratra in Hinduism and forty days of Easter in Christianity are spiritual practices observed by respective religions. These are days of mind, body and soul detoxification observed as per religion defined rituals. Broadly, they involve restraining the ten senses during the fast period. One restrains from negative thoughts cum actions and indulges in positive thoughts cum actions.

In Ramadan, the one-month continuous fast detoxifies the mind, body and soul and reenergizes the human being. Taking precautions can help people exercise better control over their health conditions even during fasting.

Some tips from HCFI

  • Monitor blood sugar level frequently.
  • Do not overeat. Pay attention to body signals and understand hunger.
  • Make sure to break the fast with sugar-free and decaffeinated drinks to avoid dehydration
  • Consume sweets in a limited amount.
  • Make sure to include lot of fruits, vegetables, pulses, and curd in your diet
  • Allow a time interval of at least 2 hours between the meal and bedtime. It is a good idea to avoid complex carbohydrates right before bedtime.
  • Avoid deep fried foods. Also, make sure to time the consumption of starch-containing foods such as rice and rotis.

Malaysia: Social Media ordered suicide of a teen girl. Know the sad story and dark side

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Never ignore any post of social media, which suggests suicidal ideation. It is a medical emergency. Never take it lightly.

Not just on social media, if someone calls you that I am feeling like committing suicide do not take it lightly.

Most patients who commit suicide successfully will talk to someone minutes before they commit suicide. The commonest precipitating factor is that they are not been loved or cared by the society.

A 16 year-old girl has reportedly killed herself in Malaysia, after posting a poll on her Instagram account asking followers if she should die or not, and 69% of responders voting that she should.

The girl, who has not been named, posted the poll on the photo sharing app with the message: “Really Important, Help Me Choose D/L”.

After most responders voted for “death”, she killed herself. Her death prompted a lawyer to suggest that those who voted for her to die could be guilty of abetting suicide.

In February, Instagram announced that it will launch “sensitivity screens” to block images of self-harm. The move followed the death of British teenager Molly Russell, whose parents believe that she saw images of suicide and self-harm on the app before she took her own life in 2017 at the age of 14.

Suicidal Ideation

  • Intentional self-injurious thoughts and behavior may be suicidal or non-suicidal
  • Suicide is the 14th leading cause of death worldwide with the global suicide rate being 12 per 100,000 individuals.
  • In the US, suicide is the 10th leading cause of death with the suicide rate more than 15 per 100,000 individuals.
  • Major risk factors for suicide are psychiatric disorders, hopelessness and previous suicide attempts or threats. Impulsive aggressive behavior is also a risk factor for suicide.
  • Suicide is influenced by a combination of feelings we have about ourselves and our future (internal affect) and feelings we have about others and the world around us (external affect) including recent life experiences.
  • High impulsive behavior or alcohol/substance abuse increase the risk that suicidal impulses will be carried out.
  • Patients suspected to be at risk for suicide should be asked about suicidal ideation and intent, and, if present should be treated as an emergency
  • WHO: 12-month prevalence of suicidal ideation (thoughts) was around 2% and that the lifetime prevalence was 9%.
  • The probability of ever making a plan to commit suicide is 33% among individuals with a lifetime history of suicidal ideation; the likelihood of ever making a suicide attempt is approximately 30% in such individuals.
  • Among individuals with a lifetime history of suicidal ideation and a plan, the probability of attempting suicide was about 55%; among ideators without a plan, the probability of attempting suicide was only 15%.
  • About 60% of the transitions from suicidal ideation to suicide plan, and from plan to suicide attempt, occurred in the first year after onset of suicidal ideation.
  • More than half of individuals with suicidal thoughts do not receive mental health services.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA