Managing diabetes during Navratris with special focus on Durga pujas

Abstract

Fasting during festivals is a common practice across all religions, believed to be associated with spiritual well-being. No literature is available addressing the challenges associated with blood glucose control in patients with diabetes during the festivals of Navratri and Durga puja, which are associated with both culinary extravagances and ritualistic fasting. Fasting alternating with binge eating can result in severe metabolic alterations, increasing both morbidity and mortality in diabetes. Dietary restraint is central to ensuring adequate glycemic control during Navratris and Durga pujas. Ritualistic fasting and dietary changes should be avoided in patients with poorly controlled diabetes with multiple comorbidities. Sulfonylureas should be avoided in case of prolonged fasting. Fast should be broken whenever blood glucose is < 70mg/dl. Target blood glucose during fasting state is 100-200mg/dl. Increasing awareness among patients, highlighting the need to enjoy festivals responsibly, and promoting healthy diet habits and exercise have an important role in maintaining glycemic control during Navratri and Durga pujas.

Factors Determining the Success of Therapeutic Lifestyle Interventions in Diabetes – Role of Partner and Family Support

“…The patient can be supported through practices such as healthy eating, medical nutrition therapy, avoiding excessive outdoor meals and erratic meal patterns, selfcare practices, blood glucose monitoring, physical activity, medication administration, and management of acute complications may; all of which will enhance compliance for the effective management of diabetes during the cultural and religious occasions. 50…”

Pragmatic dietary advice for diabetes during Navratris

“…[23637] Patients are advised to limit simple sugars and products containing so. Standardized calorie-level meal pattern with a specified percentage of carbohydrate, protein and fat based on exchange lists and food stuffs allowed to be eaten during fasting can be helpful to plan complete balanced meals on individual basis.…”

Fasting practices in Tamil Nadu and their importance for patients with diabetes

“…Substitution of sucrose (table sugar) for complex carbohydrates up to 35% of total calories does not affect glycemia or lipid levels. [1112] However, foods high in sucrose are also high in calories and hence pose significant issues. An educated patient may be able to take a small portion of high caloric food during such a festival while cutting down on other sources of calories.…”

“…SMBG if done should be reviewed by the physician for course corrections for the next year's festival. [12]…”

“…[12] Among SU, glibenclamide appears to have a higher risk of hypoglycemia. [13] Patients planning for fasting >12 h may be advised to skip SU on the day of the fast and the previous night.…”