Ramadaan and type 1 diabetes

Ramadaan is a very important month for Muslims across the world and is the third pillar of Islam. According to wikipedia, the five pillars of Islam are as follows: "The Qur'an presents them as a framework for worship and a sign of commitment to the faith. They are (1) the shahada (creed), (2) daily prayers (salat), (3) fasting during Ramadan (sawm), (4) almsgiving (zakāt), and (5) the pilgrimage to Mecca (hajj) at least once in a lifetime.^"

During ramadaan muslims abstain from food, drink and sexual behaviour from sunrise to sunset.

For people with diabetes this may be a difficult time, or at least I found it to be. This is due to the fact that when everyone else is fasting, you can not and you need to eat. I often thought that I should just get a big label of my forehead that said 'diabetic on insulin - need to eat, can't fast!'. Especially when I was at school and everyone else was fasting, I would eat in the classroom or have to find some place where no-one else would see. Not really because I was hiding but because it was more considerate for the others. Many times I would not eat, just because I would feel so bad and as a result, I would go hypo.

I've realised, many hypos later, that this is not the way to do it. Now when I need to eat, especially when I'm pregnant, I just eat. I do sometimes get the shocked looks of people who see me wearing a scarf and eating but then I think that it's not really important to my life of the well being of my baby. I walked with my mom and was feeling the onset of a hypo, so I bought a cinnamon twist and ate it while I walked. Even my mom commented that people were looking at me funny and I told her the same thing, 'it is ramadaan and I understand that they expect me to be fasting but I can't. So let them focus on themselves while I focus on myself and the well being of my baby.' I should not be behaving like a criminal because I'm not. Neither should I be feeling guilty, because I have nothing to hide.

Granted I should not be openly eating in front of people that are fasting, out of consideration, but if I need to - I will. Also, God has made allowances for people with conditions like me. I pay fidya.

As is known the Muslim Judicial Council (MJC) normally calculates the amount according to the prices of rice which is the staple food of Cape Muslims. That refers to an average type of rice, not necessarily the best type available. This is bare minimum, for those who can afford we say that they can and may increase the amount according to their means  OR they may decide to hand out their fidya by calculating 2.5kg of higher quality rice and either hand it personally to the recipients of the equivalent thereof in money.

This year the minimum amount for Fidya is R13.00 for each day that I am unable to fast (so either 29 or 30 days, depending on when the moon is sighted). I usually use this amount together with my alms, to purchase food and deliver it to an orphanage. It helps others that are less fortunate than me.

So to all of you that are unable to fast, or have children that are unable to fast, it is not anything to be ashamed of or feel guilty about. True, it took me many years to learn, but I have and I feel a lot better :) God does not give us burdens that we are unable to bear, so why should we let the looks of others let us feel less worthy?

Now I say, if you need to eat - then eat! If they judge you, let them. It is not their place to judge you anyway. Enjoy ramadaan and all it's blessing, you deserve it and most importantly be thankful of all you have.

Morning aka all day sickness, hypos and dehydration

Hi all,

It's been a while since my last blog and that is mainly due to the fact that my head was stuck in a bowl or the toilet A LOT! Yes, many women get morning sickness during pregnancy but what it means for women with type 1 diabetes is HYPOS, possibly LOTS of them!

Here's an example: I woke up at 3am with my pump beeping that I was going low (3.5 reading). My husband got out of bed to get me juice (really sweet and supportive). I did not feel so great thereafter. I got up and went to the bathroom at 4am only to have my hubby come and clean up with a mop (rather gruesome pic but it's only human). Now this means that I'm feeling really ill and my blood sugar is dropping even faster! WHAT NOW??? I went to the kitchen and tried dates (conveniently there as it's Ramadaan). The dates seemed to work but my blood sugar was still very low.

Shame, my poor hubby had to stay up as it was time for him to eat before starting to fast. I guess no-one said it would be easy but boy does it get tough at times! At times I didn't keep anything down for the entire day. I called my gynae and then I was admitted to hospital as she was concerned about my hypos and dehydration.

So Monday morning and I'm off to the hospital, my mom driving. Luckily I packed quickly as I was sure I was going to be staying there overnight.

My gynae told me to go to main reception and that they would sort everything out for me. I have to admit that I was impressed by the efficiency of the hospital, Vincent Palotti. They knew who I was, who my dr was and called for the codes so that I could get pre-authorisation. By the time someone came to fetch me, my name was already on the boards and they were getting my bed ready. Time to change into pjs and 30mins later someone from Patchcare was there for my blood work.

The hospital was going to organise me lunch but I wasn't really hungry, so they said that they would bring me a sandwich and tea later. The drip was painful but I have to say that it worked! The nurses came and did regular checks and because they knew I was on a pump just came to ask me my readings and treat any hypos. I actually educated them on pump therapy as not many of them had seen patients on a pump.

My dr came around a few hours after being admitted to check on me. My first blood work report was done within 40mins. I have to say that even though I don't really enjoy being in hospital, it was great that my dr was proactive and had me admitted. All my blood results were fine, except I discovered that I have another antigen.

According to wikipedia:

Many pregnant women carry a fetus with a blood type different from their own, and the mother can form antibodies against fetal RBCs. Sometimes these maternal antibodies are IgG, a small immunoglobulin, which can cross the placenta and cause hemolysis of fetal RBCs, which in turn can lead to hemolytic disease of the newborn, an illness of low fetal blood counts that ranges from mild to severe.^[3]

My dr is not too concerned as I can be vaccinated and my baby can be vaccinated, after birth, as well. I knew that I would have 1 antigen, but 2 was rather shocking. At least I know that it was found early and that there are things can be done about it.

I'm back at work since Wednesday last week and the morning sickness is subsiding. I will reach the end of my first trimester tomorrow God-willing and hopefully things will improved steadily :) Dr says that there is no guarantee that it the morning sickness will totally disappear already but if I have the same situation again, they will take the same actions.

It's off to eat now as my pump is beeping again. Luckily though I am happy with the hospital, my doctors and the staff. It makes me feel more confident that I've got the right team taking care of me and my baby :)