Canadian Health Care: Life with diabetes
FASTING AND DIABETES
People with diabetes who fast during Ramadan may experience large swings in blood glucose levels, as a result of the long gaps between meals and the consumption of large quantities of carbohydrate-rich foods during the nonfasting hours. Therefore, if you have diabetes, you may be exempt from fasting. However, many people with diabetes do not want to be exempted from a religious observance that they feel strongly about. If you have Type 2 diabetes and are treated by diet alone there should be no problem with fasting during Ramadan. However, there will be major changes in the pattern of eating during this month, which may affect your diabetes. If you are treated with insulin injections, sulphonylurea tablets, or a combination of the two, you should discuss how fasting may affect your blood glucose control with your diabetes team, before Ramadan begins. 
If you are on sulphonylurea tablets and are fasting during Ramadan, you can take the tablet at the end of the fast, within 30 minutes of starting your evening meal. You must not miss the sehti, the meal before sunrise, if you are to avoid hypoglycaemia later in the day. Repaglinide (NovoNorm) can be particularly useful, as it need only be taken with a meal, thus requiring no change of treatment during Ramadan.
HOLIDAYS AND TRAVEL
Do you have any simple rules for people with diabetes going abroad for holidays?
Here is a checklist of things to take with you.
- Insulin (or tablets)
- Syringes or insulin pen and needles
- Test strips (and finger pricker) and/or meter
- Identification bracelet/necklace/card Glucose tablets
- Starchy carbohydrate in case meals are delayed
- Glucagon
- Medical insurance
- European Health Insurance Card (EHIC), which has replaced Form E111, if travelling inside the EU
- Glucogel (Hypostop).
Is it safe for someone with diabetes to take travel sickness tablets?
Travel sickness pills do not upset diabetes, although they may make you sleepy so be careful if you are driving. On the other hand, vomiting can upset diabetes so it is worthwhile trying to avoid travel sickness. If you do become sick, the usual rules apply. Continue to take your normal dose of insulin and take carbohydrate in some palatable liquid form, such as a sugary drink. Test your blood glucose regularly.
As I have diabetes should I be vaccinated when going abroad?
People with diabetes should have exactly the same vaccinations as anyone else. You are no more or less likely to contract illnesses abroad but, if you do become ill, the consequences could be more serious. In addition to the necessary vaccinations, it is very important to take protective tablets against malaria if you are going to a tropical area where this disease is found. More cases of this potentially serious disease are being seen in this country, usually in travellers recently returned from Africa or the Far East.
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