1. ارامكو السعوديه Saudi Aramco

2. ارامكو السعوديه Saudi Aramco Outline  Preparation for fasting the holy month of Ramadan  Investment in health during Ramadan  Adoption of healthy lifestyle during Ramadan  Guidelines for healthy and safe fasting  What comes after Ramadan  Conclusion

3. ارامكو السعوديه Saudi Aramco Objective The main objective is to support diabetic people fast the holy month of Ramadan in a healthier and safely manner and maintain their blood sugar levels within normal ranges (no elevation of postprandial blood sugar level and no hypoglycemia during day time)

4. ارامكو السعوديه Saudi Aramco GENERAL GUIDELINES FOR DIABETIC PEOPLE DURING RAMADAN  It important that diabetic people consult their diabetic care team before they begin to fast Ramadan to help them control their blood sugar and avoid complications

5. ارامكو السعوديه Saudi Aramco GENERAL GUIDELINES FOR DIABETIC PEOPLE DURING RAMADAN  There is more than one type of diabetes (type 1 & 2, GDM, conditional). Some need only diet to control blood sugar, while others need to take pills or insulin or combination, in addition to their special diets

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8. ارامكو السعوديه Saudi Aramco GENERAL GUIDELINES FOR DIABETIC PEOPLE DURING RAMADAN  Children and young patients with diabetes depend on daily insulin injections to control their blood sugar, where Insulin doses and timing are scheduled to match with their meals and exercise plans. Generally, those patients are not advised to fast in order to avoid high or low blood sugar, which may cause coma and serious health problems to them

9. ارامكو السعوديه Saudi Aramco  Patients who are on diet-control need to speak to their doctors before fasting. If they would be allowed to fast they have to follow the same calorie & meal plan which includes there meals: Iftar (evening), Fajr (Sahoor) and midnight GENERAL GUIDELINES FOR DIABETIC PEOPLE DURING RAMADAN

10. ارامكو السعوديه Saudi Aramco GENERAL GUIDELINES FOR DIABETIC PEOPLE DURING RAMADAN  The Iftar meal should be taken right after sunset (not to be delayed) to avoid low blood sugar, while Sahoor meal should be eaten as close to Fajr (predawn) as permitted

11. ارامكو السعوديه Saudi Aramco  Fasting diabetics who are on pills or insulin are advised to avoid exercises during daytime especially in the afternoon to avoid low blood sugar. Patients may exercise (walking) 1-2 hours after the Iftar meal for 30-45 minutes with physician’s approval GENERAL GUIDELINES FOR DIABETIC PEOPLE DURING RAMADAN

12. ارامكو السعوديه Saudi Aramco  Diabetics on Oral Pills who used to take them once a day (long acting) are advised to see their doctors as they may change the timing of the pills. General, they are advised to have one tablet at Iftar and just half at Sahoor to avoid low blood sugar in the afternoon or daytime GENERAL GUIDELINES FOR DIABETIC PEOPLE DURING RAMADAN

13. ارامكو السعوديه Saudi Aramco  Pregnant and Gestational Diabetics are advised not to fast to avoid low blood sugar, ketosis and other health problems which might be dangerous and may put them and their babies at risk GENERAL GUIDELINES FOR DIABETIC PEOPLE DURING RAMADAN

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19. ارامكو السعوديه Saudi Aramco  It is very important to monitor blood sugar before meals and before taking oral medications or insulin, record the results and show them to diabetic care team GENERAL GUIDELINES FOR DIABETIC PEOPLE DURING RAMADAN

20. ارامكو السعوديه Saudi Aramco  Diabetics in Ramadan are advised to carry their Diabetic I.D. cards and some sugar cubes or dates to be used in case of hypoglycemia (low blood sugar). Some symptoms of hypoglycemia are: (tiredness, weakness, dizziness, shaking, headache, sweat, feeling cold, blurred vision.). In case of hypoglycemia, patients are advised to discontinue fasting GENERAL GUIDELINES FOR DIABETIC PEOPLE DURING RAMADAN

21. ارامكو السعوديه Saudi Aramco  With the physician's approval, patients on diuretics are advised to take them after Iftar meal rather than after Sahoor to avoid dehydration and thirst during the daytime GENERAL GUIDELINES FOR DIABETIC PEOPLE DURING RAMADAN

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29. ارامكو السعوديه Saudi Aramco NOTES:  1 cup Hareese may replace 1 cup of rice. The allowed serving of lean meat may be cooked with Hareese  3 dates equal to one fresh fruit or 1/2 cup unsweetened fruit juice  3 pieces of Samboosa may replace the serving of meat and bread  Patients are advised to consult their dietitians to discuss their meal plan during Ramadan

30. ارامكو السعوديه Saudi Aramco