Diabetes Health Podcast Interview: Nick Jonas Beyond Type 1
Hello I'm not al. Samra Diabetes Health. Managing Diabetes is no easy task when a spiritual holiday comes along. That requires fasting. You need to ensure that your health is not compromised. Join me today as I speak to Dr Luma Khalib. Who HELPS US UNDERSTAND? Who should or should not fast during. Ramadan? And what to consider before you decide to serve the spiritual holiday that may affect your health first and foremost speak to your healthcare professional to ensure you can fast safely for instance if you take insulin during meals you need to ask your healthcare professional insulin. If any you should take when fasting what about when you break your face after dusk. Let your healthcare professional know what types of foods? You're planning to eat. This will help them. How many units of Rapid Acting Insulin? You may need to cover your meal. Doctor can leaves down to Earth. Answers is sure to eliminate all listen to her sage advice. Welcome to my show. Dr Gallon idea. Yes so Romo. Von is coming up for Muslims and I thought this would be a great opportunity for us to learn more about it. What what is rumbled on the five pillars of the staff? And it's a. It's a religious month and two lunar month that usually moves in over the year but basically more observant. Muslims are required to a fast from sunrise to sunset For a whole month For EVERY PERSON. Who's observant Muslim? They're supposed to fat but there are few exemptions that for for some people not to Do not have that model. What's the purpose of fasting to fast that there is the spiritual part and there's the health barred so the spiritual part that background? No from of mine is for Muslim to not to eat. Not to enjoy an indulgence live like food and drink so they can be closer to the poor people they can appreciate all these Little blessings that they have and make them more closer to their creator. So that's the the spurs fall apart from von from the health on as me being a physician I always try to twist it and try to understand what's the health benefit of things. There is a lot of data coming out now Showing that intermittent fasting actually can help to bolic profile of human not consuming food. Twenty four seven around the clock sometimes can almost in in a simple word reset the clock and make your body more in tune with the food. That's coming in and we act in different weight with the insulin. Getting screening. Crank to deal with food. And how is intermittent fasting defined? Is it that you fast for eight hours ten hours with you? All go fast. Intermittent fasting. You'll see a lot of data out even from the UK mainly in the United Kingdom more than in the United States are getting interested in that intermittent shots and some will do it for twelve hours. Then we'll do it for longer hours but for listening fast for for the religious purposes. It's from sunrise to sunset and that can't be variable from the season one from about falls into certain foods that they should once they break their faster. They're certain traditional foods for people. A lot of people here especially not statehood. People are not familiar with Muslim. People are not familiar with the fat. I mean most of the Christian fast they would exempt theirselves not eating one kind of food for the Muslim. It will be the whole food. You cannot eat anything or drink anything for a whole that day. That day of the fasting so it is different. Especially when you you see people talk to them or see all around physician who doesn't know about what remind as it just makes it bit hard for them to grasp the whole this whole concept so that's important for the Non Muslim people to understand what this whole fast is about. An Is there a traditional. Neil that you start with when you break your fast in the evening typically as a as a after breaking your fat. That's where a lot of the problems can happen especially in people who do have certain health problems like diabetic and all that typically traditionally if people break their fast with dates and some yogurt and then they do their their prayer and then they start their meal. that's where real real problem darts. Because we're human being. We beaten like this person has been fasting for hours. They starving they overindulge and overeat eat. And that's when we really can not get the full benefit of them and is that it for some people is that because their blood sugars low or for example people that take insulin. How does that work for them? Too fast they say they. You know they're taking insulin long acting Basil Insulin. And they're supposed to take insulin when the E so with fasting. Do They not take insulin. Because they're not eating and they only take the you know the the fast acting the rapid acting again so people with diabetes and Ramon have a very special challenge for both at risk of having glocer during the evening hours but then having very high sugars after the if dr which is the big meal in the evening so it makes it even more challenging both ways for diabetics most the majority of diabetic who are on oral agents. He just pills. The majority of them can't fast reasonably safely and they don't need to adjust their medication that much especially when they don't have high risk of having of earth are they had high-pricing before now the people who are on. Insulin is a bit of a different challenge. Because insulin like I in in a healthy individual who does not have diabetes when they fast. And that's what the study in England and all that when they fast. They've seen their insulin. Level goes really low almost undetectable levels so prevent them from having hypoglycaemia and they think. That's what may we set the insulin resistant type thing. That can happen in obese and diabetic people who take like the insulin long acting insulin or the fast acting insulin insulin. Staying in their system. They're eating or not and then can lead to be your hypoglycaemia the majority of people who elect to fast While there is still on insulin they most of them they will need to change the timing and the dose of their insulin. So sort of the fast acting insulin. You're not gonNA take any fast acting when you're not eating but even the Basil Insulin. The Long Acting. Insulin probably need to move the timing audit from if you take it in the morning you really want to move it to take it in the where the evening around the evening meal. And most of guidelines recommend to cut back does by ten fifteen to twenty percent to prevent these low sugar during the fasting hours. And what if you're on an insulin pump? Would you do the same thing? So you would adjust your basil bullish recog- a although I was reviewing some guidelines are on the safety of fasting during Ramadan. I'm not a clergy percents. So it's really hard to tell you can't believe take responsibility and saying you can fast and you cannot fast so this is a very hard decision for a personal decision to make once you get there. But in general there are few high risk markers really make people have to stop and think twice before they want to make that decision and proceed with the fast thing. And You you're well-controlled on pomp and you can feel the hypoglycemia. Continuous Glucose Monitor Daring. And he can tell when you're hypoglycemic. Then that's fine but if you don't or you have the hypoglycemia unawareness need you. Can crash down without even having warning symptoms. These are one of the categories that being placed in high risk people that really have to be very careful Before deciding fast really and free type twos as you were saying it's It's a little easier because their body does produce insulin and they're not taking insulin which could create a hike gratton episode for two diabetic. Some of them are still on insulin. But you said a very correct statement for diabetic their bodies to produce insulin and theoretically when they stop eating their own insulin. Production will start to come down and that prevent them from having significant severe. Low Sugar Action But people who are type two are still taking some basil and so on. They definitely can talk. I doubt dozes at that for just to go back on the pump s setting They really have to cut down on their Basal Insulin. Even they may change their car issues. That will be very personalized. Very specific tailored program and change to each person would have to have different recommendation. Do you do you feel overall that Muslims at have diabetes understand the risks associated with fasting or not are they defeated on that or I wouldn't say well educated. I don't think anybody really have paid much attention on. Not just for for patient even for physicians. I've been trained here in the United States and I don't recall really getting specific education forum on what to do when I have a patient come through to the clinic But in general Muslim people have good experience with that thing because probably facet. Before they became diabetic they fasted all along with the medication changes. So they have experienced but I don't I don't think they have really good education and that's why we're really trying to increase the awareness for physicians and for the community and community to be more aware of what's going on and what are the risk factors. And what are the things that they need to look for? Which medication that needs to be adjusted than others? This is for the patient the Healthcare Professional. I would say both I mean here and where where what I practice. We twee trying to reach out to the community and we've been giving lectures at the community center and in the same time trying to raise awareness for physicians to to know what Rama Ban and what to look for. There are a lot of really good resources links. Like the American Diabetes Association. International degration of diabetes have done amazing work to help guide physicians to help their patients. And how can people observe Ramadan in way? Witter some tips that they would could help them in terms of maintaining better blood sugars really a diabetic for all of Austral. All people her fat thing. The main thing is to keep well hydrated especially where among comes in in a long summer or like bring Month at dehydration is a main thing so keeping hydrated knock with sugary drinks. Not with sodas as you know for diabetics that will be a big obstacle but Hydration low sugar or no calorie fluids and to eat balanced diet to do multiple meals rather than just one big meal and skip the Asahara. Which is the early morning meal? 'cause that will make a higher burden on their body to to keep topping certain people that are exempt from fasting with your practicing Muslim. Would there be one caveat or some caveats where it's okay for you not to observe Ramadan shontae. In general religion really look for for Like make things simplified rather than complicated so it's into Peron in the second verse is There is a specific Sculpture there is if you are sick traveling then you can. You don't have to fast but you have to make it up and other days which is easy to do for an acute illness. But if it's a chronic illness like diabetes is. It's not going to go away. So the diabetic person have a couple of option. Either try not to fast when the days are long and try to make it up and other days and that's possible because they're exempt the other option is if they think it's face to fact and what does the best ways to work with their healthcare provider to make it safe for them to fast So that's would be an option and the third option if their healthcare provider themselves or their clergyman. I'll think that they are very high. Risk too fast than they are exempt. Are there any other tips that you would like to give people with diabetes or healthcare professionals? I would say knowledge best. Thank you will not know things you will I mean for even for my students For any diagnoses. If you don't know what you're looking for you want find it so knowing what your risk? Now at one of the symptoms of sugar was the high sugar. What could go wrong so read? Listen to programs like the one that you're doing now Would be really the best thing that you can help yourself help your family and make sure that you have a blessed month and healthy month right will thank you so much for joining us today talk. I'm not yet. It's been a pleasure to be part of your team for those of you. Observe Ramadan I wish you the best health from diabetes health. I'm not out Samri.