Doha: The Primary Health Care Corporation reiterated the importance of individual medical assessments for chronic disease patients to determine their health capacity for fasting during the remaining days of the holy month of Ramadan, particularly for those with diabetes, heart, kidney, or respiratory conditions.
According to Qatar News Agency, Dr. Rand Silwan Abbood, a family medicine specialist at the Primary Health Care Corporation, stated that fasting represents a health challenge for chronic disease patients, making medical evaluation crucial. Many patients advised by their doctors not to fast do not follow this guidance, which may lead to health complications.
Dr. Abbood clarified that the ability to fast depends on an accurate classification of health risk levels. She noted that some cases are medically advised not to fast at all, while other categories may fast under medical supervision with treatment adjustments and continuous monitoring.
She explained that the health risk classification for fasting is divided into several categories: very high-risk cases, high-risk cases, moderate-risk cases, and low-risk cases. Fasting is medically not recommended for "very high-risk cases," which require an alternative and safe treatment plan. This category includes uncontrolled diabetic patients, severe hypoglycemia episodes, advanced kidney failure or dialysis patients, unstable heart disease, active chemotherapy, high-risk pregnancy, and children with chronic illnesses.
Fasting in the "high-risk cases" category is allowed with caution after prior medical evaluation and close monitoring. This includes uncontrolled diabetic patients or those using insulin, stable heart failure, stage three kidney failure, controlled epilepsy, uncomplicated pregnancy, and stable breastfeeding mothers.
For "moderate-risk cases," patients may fast under medical supervision with medication adjustments. This includes relatively controlled diabetic patients, controlled hypertension, stable coronary artery disease, mild asthma, stable thyroid insufficiency, and early-stage kidney disease.
In "low-risk cases," fasting is generally safe with simple medical guidance. This category includes patients with stable chronic illnesses on once-daily medication with good treatment adherence.
Dr. Abbood highlighted regional statistics showing that approximately 78 percent of type 2 diabetic patients and 42.8 percent of type 1 diabetic patients fast during Ramadan. However, between 30 to 50 percent of patients adjust or stop medications without medical consultation, while around 59.4 percent modify treatment doses, increasing the risk of blood sugar disturbances, dehydration, and health instability.
Studies in the Middle East show that about six percent of patients experience occasional hypoglycemic episodes during Ramadan, and approximately 2.5 percent require hospitalization due to low blood sugar.
Dr. Abbood explained that abstaining from food, fluids, and oral medications from dawn to sunset causes physiological and behavioral changes affecting body balance, including altered sleep and meal schedules and medication usage, which can directly impact the stability of chronic conditions.
She clarified that during the initial hours of fasting, the body consumes glycogen stores before shifting to fat as an energy source. This increases risks of dehydration and low blood pressure, particularly in older adults and patients using diuretics or blood pressure medications.
Dr. Abbood advised that physiological and treatment considerations during Ramadan require adherence to several health guidelines. She emphasized avoiding medications that may negatively affect kidney function while fasting, monitoring for dizziness, falls, and fatigue, regularly checking blood sugar and blood pressure, adjusting some diabetes treatments to reduce hypoglycemia risk, limiting excessive caffeine and diuretic beverages, and reviewing medication doses and usage during and after Ramadan.