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Management of diabetes during Ramadan !

Muslims are required to fast during the month of Ramadan from sunrise to sunset.

However, there are exceptions to this. One of them is that people who are ill or have medical conditions do not have to fast. This includes some people with diabetes.

Patients should be stratified into their risk of hypoglycemia and/or the presence of complications prior to the beginning of fasting. Patients at high risk of hypoglycemia and with multiple diabetic complications should be advised against prolonged fasting.

Agents such as metformin, α-glucosidase inhibitors, TZDs, and DPP4 inhibitors appear to be safe and do not need major dose adjustments.

Sulfonylureas and insulin secretagogues should be used with extreme caution during Ramadan fasting, in particular chlorpropamide or glyburide, which are associated with increased risk of hypoglycemia. The dose of sulfonylureas should be reduced or the medication stopped before the start of the fast, depending on the degree of glycemic control, kidney function, and presence of diabetic complications. There is increasing knowledge on the efficacy and safety of DPP4 inhibitors as monotherapy or in combination with metformin therapy. The use of DPP4-inibitors appears to be safe and with low rates of hypoglycemia. The use of GLP-1 RA may also be of benefit in obese patients in improving glycaemic control and in reducing appetite during Ramadan. There is no data on the safety and efficacy of SGLT-2 inhibitors during the fasting period of Ramadan.

Algorithm for premixed insulin titration during Ramadan (adapted from Hassanein et al23)

Fasting pre-Iftar pre-Suhoor BG Insulin adjustment
>16.6 mmol/L (300 mg/dL) Increase insulin daily dose by 20%
>10 mmol/L (180 mg/dL) Reduce insulin daily dose by 10%
5.5–10 mmol/L (100–180 mg/dL) No change
<5.5 mmol/L (100 mg/dL) or symptoms Reduce insulin daily dose by 10%
< 3.9 mmol/L (70 mg/dL) Reduce insulin daily dose by 20%
<2.8 mmol/L (50 mg/dL) Reduce insulin daily dose by 30–40%

Patients with type 1 and type 2 diabetes treated with insulin should be educated on the appropriate use of insulin administration and the need for glucose monitoring during the fasting period. Most patients require a modification of the basal insulin dosage and on the use of premeal insulin to cover meals after breaking of the fast. In some patients, a larger insulin dose may be needed after a large evening meal. The use of basal insulin analogs and continuous insulin infusion may be of benefit as they cover basal requirements without significant peaks and may result in less hypoglycemia compared with human NPH and premixed insulin. The drawbacks of insulin analogs and insulin pump therapy are the cost and limitations of technology support in some countries. Finally, patients should be instructed that POC testing does not break the fast and that glucose monitoring may reduce the risks of hypoglycemia in patients receiving insulin secretagogues and insulin therapy.

http://drc.bmj.com/content/3/1/e000108.full#aff-4

 
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Posted by on June 21, 2015 in Relax

 

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Muharram & The Day of Aashora

Allah’s sacred month of Muharram is a blessed and important month. It is the first month of the Hijri calendar.

Muharram itself means `sacred’ and is from those months which have been mentioned as sacred in the Holy Quraan.
 Almighty Allah states in the Holy Quraan:

“Four of them ( Zil-Qadah, Zil-Hijjah, Muharram and Rajab) are sacred.”

(Surah At-Tawbah:36)
 The Holy Prophet Muhammad (Sallallahu-Alayhi-Wasallam) said:“The best of fasts besides the month of Ramadhan is the fasting of Allah’s month of Muharram.”‘Ashura’ is the tenth day of Muharram and Tasu’a’ is the ninth day.”The Prophet (peace and blessings of Allah be upon him) came to Madinah and saw the Jews fasting on the day of ‘Ashura’. He said, ‘What is this?’ They said, ‘This is a righteous day, it is the day when Allah saved the Children of Israel from their enemies, so Musa fasted on this day.’ He said, ‘We have more right to Musa than you,’ so he fasted on that day and commanded [the Muslims] to fast on that day.” [Reported by al-Bukhari, 1865]The Holy Prophet (Sallallahu-Alayhi-Wasallam) said:“Observe the fast of Aashora and oppose the Jews.  Fast a day before it or a day after.”

(Baihaqi)
‘ The Prophet (saws) said, ‘When the following year comes–Allah willing–we shall fast (also) on the ninth.’

Sunan of Abu-Dawood 2419 (part)       Narrated by Abu Qatadah

The Messenger of Allah (saws) said: ‘…..I seek from Allah that fasting on the day of ‘Arafah’ may atone for the sins of the preceding and the coming year; and I seek from Allah that fasting on the days of ‘Ashura’ may atone for the sins of the preceding year.’

We ask Allah to make us followers of the Sunnah of His Noble Prophet, to make us live in Islam and die in a state of faith. May He help us to do that which He loves and which pleases Him. We ask Him to help us to remember Him and be thankful to Him, to worship Him properly and to accept our good deeds.

 
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Posted by on November 12, 2013 in Relax

 

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Ramadan and Time Robbers

Ramadan comes with a full package of opportunities and spiritual environment that no one can deny: Fasting and patience, iftar parties and the social aspect, taraweeh prayers and Qur’an recitation…etc. All of that are great and they put you (or force you) in the Ramadan zone.

However, your battle with your desires and your inner-self (nafs) isn’t over. The only change is in the battleground and hence in the weapons used and the potential “casualties”. In this article we talk about a weapon that tends to take over many Muslim minds and hearts in Ramadan: Time Robbers.

Continue reading:

Ramadan and Time Robbers – Practical Programs – Shari`ah – OnIslam.net.

 
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Posted by on July 11, 2013 in Relax

 

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Fasting twice a week can help protect against brain diseases, scientists

Fasting can help protect against brain diseases, scientists say

Claim that giving up almost all food for one or two days a week can counteract impact of Alzheimer’s and Parkinson’s

Posted Image
A vertical slice through the brain of a patient with Alzheimer’s, left, compared with a normal brain, right. Photograph: Alfred Pasieka/Science Photo Library

Fasting for regular periods could help protect the brain against degenerative illnesses, according to US scientists.
Researchers at the National Institute on Ageing in Baltimore said they had found evidence which shows that periods of stopping virtually all food intake for one or two days a week could protect the brain against some of the worst effects of Alzheimer’s, Parkinson’s and other ailments.
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Professor Mark Mattson
“Reducing your calorie intake could help your brain, but doing so by cutting your intake of food is not likely to be the best method of triggering this protection. It is likely to be better to go on intermittent bouts of fasting, in which you eat hardly anything at all, and then have periods when you eat as much as you want,” said Professor Mark Mattson, head of the institute’s laboratory of neurosciences.
“In other words, timing appears to be a crucial element to this process,” Mattson told the annual meeting of the American Association for the Advancement of Science in Vancouver.
Cutting daily food intake to around 500 calories – which amounts to little more than a few vegetables and some tea – for two days out of seven had clear beneficial effects in their studies, claimed Mattson, who is also professor of neuroscience at the Johns Hopkins University School of Medicine in Baltimore.
Scientists have known for some time that a low-calorie diet is a recipe for longer life. Rats and mice reared on restricted amounts of food increase their lifespan by up to 40%. A similar effect has been noted in humans. But Mattson and his team have taken this notion further. They argue that starving yourself occasionally can stave off not just ill-health and early death but delay the onset of conditions affecting the brain, including strokes. “Our animal experiments clearly suggest this,” said Mattson.
He and his colleagues have also worked out a specific mechanism by which the growth of neurones in the brain could be affected by reduced energy intakes. Amounts of two cellular messaging chemicals are boosted when calorie intake is sharply reduced, said Mattson. These chemical messengers play an important role in boosting the growth of neurones in the brain, a process that would counteract the impact of Alzheimer’s and Parkinson’s.
“The cells of the brain are put under mild stress that is analogous to the effects of exercise on muscle cells,” said Mattson. “The overall effect is beneficial.”
The link between reductions in energy intake and the boosting of cell growth in the brain might seem an unlikely one, but Mattson insisted that there were sound evolutionary reasons for believing it to be the case. “When resources became scarce, our ancestors would have had to scrounge for food,” said Mattson. “Those whose brains responded best – who remembered where promising sources could be found or recalled how to avoid predators — would have been the ones who got the food. Thus a mechanism linking periods of starvation to neural growth would have evolved.”
This model has been worked out using studies of fasting on humans and the resulting impact on their general health – even sufferers from asthma have shown benefits, said Mattson – and from experiments on the impact on the brains of animals affected by the rodent equivalent of Alzheimer’s and Parkinson’s. Now Mattson’s team is preparing to study the impact of fasting on the brain by using MRI scans and other techniques.
If this final link can be established, Mattson said that a person could optimise his or her brain function by subjecting themselves to bouts of “intermittent energy restriction”. In other words, they could cut their food intake to a bare minimum for two days a week, while indulging for the other five. “We have found that from a psychological point of view that works quite well. You can put up with having hardly any food for a day if you know that for the next five you can eat what you want.”

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O you who believe fasting is decreed for you, as it was decreed for those before you, that you may attain salvation. Specific days (are designated for fasting); if one is ill or traveling, an equal number of other days may be substituted. Those who can fast, but with great difficulty, may substitute feeding one poor person for each day of breaking the fast. If one volunteers (more righteous works), it is better. But fasting is the best for you, if you only knew. Quran 2:183-185

((يَا أَيُّهَا الَّذِينَ آمَنُواْ كُتِبَ عَلَيْكُمُ الصِّيَامُ كَمَا كُتِبَ عَلَى الَّذِينَ مِن قَبْلِكُمْ لَعَلَّكُمْ تَتَّقُونَ. أَيَّامًا مَّعْدُودَاتٍ فَمَن كَانَ مِنكُم مَّرِيضًا أَوْ عَلَى سَفَرٍ فَعِدَّةٌ مِّنْ أَيَّامٍ أُخَرَ وَعَلَى الَّذِينَ يُطِيقُونَهُ فِدْيَةٌ وَعَلَى الَّذِينَ يُطِيقُونَهُ فِدْيَةٌ طَعَامُ مِسْكِينٍ فَمَنْ تَطَوَّعَ خَيْراً فَهُوَ خَيْرٌ لَهُ وَأَنْ تَصُومُوا خَيْرٌ لَكُمْ إِنْ كُنْتُمْ تَعْلَمُونَ ))

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It was narrated that ‘Aishah said:

“The Messenger of Allah used to be keen to fast on Mondays and Thursday.” (Hasan)
أَخْبَرَنَا إِسْحَاقُ بْنُ إِبْرَاهِيمَ، قَالَ أَنْبَأَنَا عُبَيْدُ اللَّهِ بْنُ سَعِيدٍ الأُمَوِيُّ، قَالَ حَدَّثَنَا سُفْيَانُ، عَنْ ثَوْرٍ، عَنْ خَالِدِ بْنِ مَعْدَانَ، عَنْ عَائِشَةَ، قَالَتْ كَانَ رَسُولُ اللَّهِ صلى الله عليه وسلم يَتَحَرَّى الاِثْنَيْنِ وَالْخَمِيسَ ‏.‏

http://sunnah.com/urn/1123710

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Source
http://www.guardian….ases-scientists
http://esciencenews…..scientists.say
http://healthwirenew…y-the-guardian/

 
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Posted by on February 20, 2012 in News

 

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