fasting and diabetes dr shahkur shabir gp st2 half day release november 2011
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Fasting and Diabetes
Dr Shahkur ShabirGP ST2
Half Day ReleaseNovember 2011
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What is fasting?
• Fasting is an important spiritual aspect of many religions, such as Islam, Hinduism and Judaism.
• It is the abstinence from food (and sometimes drink),
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Who fasts
• Depending on the religion, fasting will last for different lengths of time.
• In Hinduism and Judaism there tend to be individual days of fasting.
• However, the Islamic month of Ramadan is one of the longest periods of fasting, when it is compulsory for all healthy Muslims to fast between the hours of sunrise and sunset.
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However, people with diabetes do not have to fast during Ramadan.
Many people still wish to fast.
So its our duty to advise them best we can.
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Type 1 diabetes
• Type 1 diabetes:• danger of high blood glucose levels (known as
hyperglycaemia) and result in a build up of 'ketones'.
• This could potentially result in a serious condition known as ketoacidosis.
• The symptoms of high blood glucose levels might include feeling very thirsty, passing a lot of urine and/or extreme tiredness.
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Advice for people with diabetes who choose to fast
• The type of insulin may also need changing from your usual type.
• Check your blood glucose levels more often.
• Continue a varied and balanced diet.
• Try not to have too many sugary and fatty foods.
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• Include more slowly absorbed foods that have a lower glycaemic index. – Examples: rice, pasta, wheat
• When you break the fast, ensure you drink plenty of sugar-free and decaffeinated drinks to avoid dehydration.
• Speak to your healthcare team if you are planning to fast.
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IMPORTANT TO EDUCATE RISKS OF DIABETES
Hypoglycaemia- can lead to collapse and fitting.
A responsible person in the family should be supplied with Glucose gel (hypostop) and Glucagon injection.
Give oral sugar as soon as patient is conscious.
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OTHER COMPLICATIONS• Diabetics are 2-5 times more likely to have MI
and 3 times Strokes.
• Badly controlled Diabetes can lead to Kidney failure and patient may end on dialysis.
• 1 in 3 patients have eye problems on the time of diagnosis.Diabetes increases the risk of cataract, Glaucoma and retinopathy-(can lead to blindness).
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Autonomic Neuropathy
• Postural Hypotension
• Erectile Dysfunction
• Urinary retention
• Diabetic diarrhoea
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• Diabetes predisposes patients to Depression
• PERIPHERAL NEUROPATHY- Reduced foot sensation which can lead to ulcers.
• AMYOTROPHYPainful wasting of quadriceps muscle
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• It is important to respect all religions and patients beliefs.
• It is our duty to best advise the patient of possible risks so they can make an informed decision.
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THANK YOU