A total of 216,887 people aged 20 to 79 years and representing some 14% of the adult population in Qatar are diabetics, according to the Qatar Diabetes Association.

By 2030 the estimated number of people suffering from diabetes in Qatar is set to double, accounting for 20.9% of the adult population.

Inappropriate nutrition, unhealthy lifestyles and lack of exercise must be addressed to decrease the risk of developing diabetes.

In order to prevent the risk of diabetes, an Action on Diabetes campaign was launched late last year as a partnership between the Supreme Council of Health, Hamad Medical Corporation, Qatar Diabetes Association, Maersk Oil Qatar and world leader in diabetes care Novo Nordisk.

The aim of the campaign was to develop a programme that works in Qatar – applying the best international knowledge and experience but also understanding how Qatar is different.

“Although people who are ill or have type one diabetes do not have to fast, most diabetic Muslims often want to fully involve themselves in the religious occasion and this can present some health challenges if they are not well informed about how to practise it safely,” QDA executive director Dr Abdulla al-Hamaq said.

Dr al-Hamaq maintained that it was possible for people diagnosed with diabetes to be able to fast, stressing that in order to do it safely, they should first consult with their doctor and religious leader to take the appropriate decision.

“If people with diabetes do choose to fast then it is crucial that they follow certain steps in order to help reduce the chances of becoming ill,” QDA senior dietitian Katie Nahas, said while sharing advice on how to manage diabetes while fasting.

She explained that the main risks for people living with diabetes at all times, and most significantly during fasting, are low and high blood sugar levels, in addition to the alternation between both, as well as the risk of dehydration.

“That’s why it is crucial that diabetics keep monitoring their blood sugar throughout fasting. If it reaches a level equal or above 300 or equal or below 70 then they need to break their fast. They should then consult with their doctor to adjust their medication if they wish to continue fasting,” she advised.

Nahas proposed that when breaking fast with yogurt and dates, rather than indulging on dates, people should limit themselves to three.

“Dates are a great source of simple sugar when eaten in moderation. Too many will cause blood sugar to rocket which is not good, particularly for diabetics.”

However, Nahas advised that the tendency to moderation should be practised by everyone during Ramadan saying: “It’s about making choices. Instead of choosing to eat a number of foods that have a high impact on blood sugar all in one sitting, choose your two favourites and save the others for the next meal.”

Foods that have a high glycemic index include fruit juices, fatayer, white bread, rice and traditional dishes such as Blaleet, Muhalabiyeh and Awamat.

“Once the majority of your hunger is satisfied, then move onto eat other foods that are less healthy when consumed in larger quantities,” she said.

Nahas also emphasised the need to delay Suhour for as long as possible, “Ideally those with diabetes, and even those without, should wake up and have a complete meal that consists of protein and carbohydrates rich in soluble fiber, like oats and beans, in the early hours of the morning. This helps them stay feeling full and stabilises blood sugar for longer during fasting.”

It is recommended that people should drink water continually during non-fasting hours and reduce juices intake in order to hydrate.

“Fruit juices increase blood sugar a lot and very rapidly, so try drinking just half a cup. Ideally, the majority of your fluid intake should come from drinking water. Also, if diuretics such as tea of coffee are taken then it is important to drink more water to counteract the effects,” she maintained.

Lifestyle considerations, such as taking part in light exercise during non-fasting hours is advocated, with the special night prayer of Taraweeh providing an ideal source of movement for all ages.

Nahas cautioned those with diabetes against sleeping while fasting saying: “Decreased food intake is a well-known risk factor for the development of hypoglycemia. If a fasting diabetic is asleep they risk not being aware of symptoms of hypoglycemia and cannot take the necessary measures to counter this.

It’s very important that diabetics always carry an emergency snack with them at all times, such as candies or a carton of juice.”