Most women with Gestational Diabetes have many concerns. Especially when the holy month of Ramadan is approaching. All are in a dilemma. Should I fast or not? A question that repeats itself and that even the latest medical research can’t give a clear answer to it.
During pregnancy, many physiological changes happen to the body. This includes an increase in insulin resistance and secretion. This requires serious evaluation before the beginning of the month of Ramadan, and continuous monitoring during it. That is because insulin resistance leads to high blood glucose. Meaning high A1C levels which are related to congenital malformations meaning abnormalities and defects that appear in an infant right from birth.
Therefore, from a medical point of view, doctors usually strongly advice pregnant women with Gestational Diabetes against fasting for Ramadan.
From a religious point of view, pregnant women with gestational diabetes are exempt from fasting during the month of Ramadan. However, some women insist on fasting during the holy month.
However, the vast majority of Muslim women with gestational diabetes opt to fast in the month of Ramadan despite medical and religious advice not to do so. If you are one of them and you decide to fast during Ramadan, then the following is recommended:
1| A thorough full medical assessment around 1-month before Ramadan. Make sure blood sugar, blood pressure and blood lipids are well controlled.
2| As a lady with gestational diabetes, doctors should inform you that fasting Ramadan increases the risk of hypoglycemia (low blood sugar). In case you are treating this with diet alone or with diet & medications and that you are still at risk of getting some complications because of the eating and other habits during the month of Ramadan.
3| Following up on a regular basis both with your gynecologist and your endocrinologist- and this is a crucial point.
4| Doctors should provide you with proper nutritional education, following up with a clinical dietitian (in coordination with the endocrinologist). Along with a pre-set fasting plan to prevent both low and high blood sugars.
In conclusion, the above is just our opinion and any decision you take should be in consultation with both your gynecologist and endocrinologist.
Lara Chebli, Intensive Care Clinical Dietitian