Got questions about navigating life with diabetes? Welcome to our weekly advice column, Ask D'Mine — the place to get some colorful answers from veteran type 1, diabetes Ask-DMine_buttonauthor and educator, Wil Dubois.

This week, Wil takes a look at the saints of diabetes and how PWDs handle the annual celebration of Ramadan, the annual month of fasting for Muslins worldwide that begins on July 8.

{Got your own questions? Email us at AskDMine@diabetesmine.com}

 

Melissa, type 1 from Illinois, writes: Hi, Wil. I'm a devout Muslim and a relatively new diabetic. I use an OmniPod insulin pump and my control is pretty good, but this will be my first Ramadan with diabetes. Any advice on how to set my pump for the month of fasting?

Wil@Ask D'Mine answers: Diabetes scholar, yes. Religious scholar? No so much. So I had to spend some time on Google to get what I hope are the correct facts about Ramadan fasting. So for those of you not in the know, Melissa isn't talking about fasting for the whole month of Ramadan; her faith asks her to fast from Sunrise to Sunset during this one month each year. While that can be difficult for many people, it's probably not overly risky — but for a type 1, not eating for most of the day can be fraught with danger.

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Egyptian physician Mahmoud Ashraf Ibrahim and his colleagues created a special set of Ramadan recommendations for the ADA magazine Diabetes Care back in 2005 that's well worth reading for more detail than I have room for here, but their advice to type 1s is: Don't do it. The risks are too high. That said, I understand that this may not be a religious option for you personally or for your particular mosque. Various religions provide various hall passes for various members for various reasons. Some Ramadan sources seem to indicate that people with type 1 are "normally exempt" from the requirement of fasting during Ramadan, while other sources state that if you are sick, pregnant, or traveling, you are not expected to fast — but that you need to make it up later.

Can you ask your Imam if you can wait until the cure?

Please take no insult. I wasn't making fun of your faith. Actually one study shows that more than 40% of Muslim type 1s do fast for Ramadan. So let's talk about how to do it smartly and safely.

We need to talk about increased blood sugar monitoring, temporary basal rates, and not being a bonehead if you go low. Let me start with that last one first. If you have a low blood sugar during your fast, you must, must, must treat it. Fasting be damned, and I don't think you will be for saving your own life. Waiting for sundown is not an option when you are hypo, even if the sun is low in the sky.

Next, let's talk about pump basal rates. So here's the deal, in theory: if your basal rate is set right, you could fast until you starved to death, and your blood sugar would remain perfect. In reality, most of us don't really have perfect pump rates. I'd suggest you experiment with running a reduced temp rate all day during Ramadan fasting. How reduced? Mohammad only ramadanknows. Probably between 25% and 50% less than your normal drip. Get your medical team's advice, but if you have to guess, start with the 50% and see what happens. It's safer to run a hair high on the first day or two than risk a low. You can then adjust the rate as you go along. Experience and careful monitoring of your blood sugar will guide you. (And for any of my Muslim D-brothers and D-sisters not using a pump, here are some recommendations on how to change your injection dosing if you need/want to fast.)

Right, so speaking of monitoring: test, test, test, test. Test like you've never tested before. God gave you ten fingers, use them! At least for the first few days, until you know the lay of the land. And test intensively again if you have a Ramadan day where you are more physically active than on the typical day.

But I have one last worry, and this one has me lying in bed at night staring at the ceiling, rather than sleeping like a baby. You didn't have diabetes for last year's Ramadan. That tells me you've had your diabetes for less than a year. Frankly, I'm freaked out that you might still be in your honeymoon phase where your beta cells aren't all quite dead yet. Some days you are producing more insulin than other days. That means even if your pump is perfect, your body could betray you. Again, I don't want to tread on your faith, but I really do want you alive to celebrate many more Ramadans to come.

There are some more resources out there, like what Lilly is now doing with the Qatar Diabetes Association - check that out here. I'm sure there are more resources, but Dr. Google might help out more than I can on some of those options.

I know time is short with Ramadan right around the corner, but I think your doc and your Imam should chat with each other. As your type 1 is new, maybe you should sit this one out. Get a hall pass to get past the honeymoon phase. Get comfortable with the diabetes.

Then take on the Ramadan fast next year.

 

Michael, type 2 from Massachusetts, asks: Is there a Patron Saint for Diabetes?

Wil@Ask D'Mine answers: Trust me on this, there's a Patron Saint for everything under heaven, including diabetes. In fact, there are several to choose from. More on that in a minute, but first let me set the saintly stage. Now, I confess, I just love saints, but it's more a matter of geography than religion. At the risk of being too personal, I was raised in the Anglican church (a.k.a. Episcopal). We have saints, I think, but we don't make too big a deal out of them.

However, I live in Catholic New Mexico where some people might argue that saints are, well, bigger than God. I know I'm going to get hate mail for saying that, but there are saints everywhere out here. I've been on medical home visits where I've seen tiny shrine-like private residences that boast more saints than the typical Spanish Cathedral! In my neck of the woods, saints medals are more common than medic alerts, retablos dominate private and public spaces, and classified ads are full of published thank you's to assorted saints for services rendered. Hell, houses in the Southwest are even built with "nichos," special alcoves in walls to hold statues of saints. And yes, I do realize that I just swore while talking about saints and religion. Did you expect any less from me?

I love saints, in a secular way, for two reasons. First, the artwork is beautiful. Check out this collection from one of my favorite shops on the Santa Fe Plaza. But what really makes saints fun is their specialties. What you may not realize is that most saints, like me, are heavy multitaskers. Rare is the saint with only one job.

For instance, there's Saint Barbara, who is patron of miners, firework makers, mathematicians, prisoners, and the service men of the Russian Strategic Rocket Forces. And there's Saint Catherine who is patron of librarians, teachers, archivists, and truck drivers. Saint Sebastian is responsible for soldiers, archers, athletes, and people suffering from the plague. Saint Amand, rather paradoxically, it seems to me, is charged with both Boy Scouts and brewers—along with innkeepers, merchants, and vine growers. Or a couple of my favorites: St. Francis de Sales who is patron of both the deaf and journalists—was well as the city of Cincinnati; and Santa Agatha who's patron of breast feeding professionals (a.k.a. "wet nurses"), garden variety medical nurses, and jewelers. You also invoke her to intercede in cases of breast cancer and to ward off volcanoes. Wait a sec. What on earth do volcanoes and nurses and breast cancer have to do with each other? That's too long a story to tell here, but if you look hard enough, most saint's life-histories in some way or another connect them to their post-mortal specialties.

And to make saints even more fun, a great many of them led pretty rowdy lives before finding religion, or in some cases, being found by religion.

Of course, Popes make saints, but how a saint becomes a Patron of anything is a little more complicated. To be officially licensed, certified, and sanctified as a Patron involves an outfit called the Congregation for Causes of Saints at the Vatican. But other times, popular appeal seems to rule the day.

Anyway, back to your question. Yes. We have at least two "official" Patron Saints of Diabetes.

The first is St. Josemaria Escriva, and being a very modern saint, he even has his own website. How did he become oSaint Paulinene of the leading contenders for Diabetes Sainthood? Well, the story goes that he went into anaphylactic shock in 1954, survived that, but came down with diabetes, which was then miraculously cured a decade later. He died (not of diabetes) in 1975 and was canonized in 2002. And if his name sounds familiar to you, he's the guy who founded the controversial Catholic institution Opus Dei of Da Vinci Code fame.

If you feel the need for a less controversial Diabetes Saint, you could try out St. Pauline Visintainer, who had the misfortune to die of diabetes complications in 1942. Oh, and if you're into creepy saint's relics, one of her finger bones is right here in the USA. For the morbid among you, yes, it's true her right arm was amputated due to diabetes complications some time before her death, but the finger bone relics are from the arm that was still attached to her when she died.

If you want an older, more established saint, you could think outside the box and use St. Benedict. He's the patron of kidney disease (and agricultural workers, civil engineers, inflammatory diseases, Italian architects, students and school children, spelunkers, and all of frickin' Europe). Or maybe you worry more about your eyes. The Patron Saint of eyes and eye health, well, one of them anyway, is St. Lucy. Like any proper Medieval saint she has her eyes on a lot of things, including epidemics, martyrs, salesmen, the city of Syracuse, throat infections, and even writers. Thanks for your help today, St. L!

And failing any of those, here's a complete list of all the saints charged with "chronic and incurable" illnesses. Hundreds to choose from!

Happy prayers.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

 
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This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.