India is a religious country. Fasting is seen in almost all the religions and considered to be a very important ritual to be performed. In Hinduism, there are almost 104 fasts which are to be performed weekly, monthly, done in trimester or semester. In Muslims, fasts are kept and are called as 'Ramzan'. Fasts are kept once in a year but for one month. In Jainism too, fasts are very essential. Conclusion is, fast is accepted and practiced in almost all religions in one or the other form. But, what is the importance of these fasts?

For this, we need to study the experiments conducted on fasting in various countries. Scientists of medical fields from London, America, Germany, Japan etc..... have proved the benefits of fasting in various disorders like arthritis, heart diseases, high blood pressure, cancer of intestine and digestive system and other digestion related disorders. Results have shown that fasting decreases the dosage of medications and prove to be more beneficial in comparison to medicines. At the same time, work efficiency of various organs too increases.

Question arises whether in all the diseases, fasting proves to be beneficial from scientific view? From scientific view, it's difficult to say that fasting proves to be beneficial in almost all diseases because yet studies are been conducted in this aspect. Among these diseases, one of them is diabetes. This is a controversial issue whether diabetic patients should fast or should not. Modern age doctors strongly recommend diabetic patients not to fast. Whereas doctors from ayurvedic and naturopathy fields start the treatment by making the patient to fast. They even stop the patient's intake of insulin. Benefits are observed within a few days after initiation of their therapy. Their treatment clearly indicates that fasting does not harm diabetic patients.

Diabetic patients are of 2 types. First type is one who are dependent on insulin. They are called as I.D.D.M. Other type is one who controls diabetes by intake of medications. They are called as N.I.D.D.M. If an individual is N.I.D.D.M. and tries to control diabetes through medications, exercise or food then he should take care of certain things. If disease is new i.e., if diabetes has developed recently and symptoms are been seen since few days, if his blood sugar level is not very high and doctor has asked him to control diabetes through diet and exercise then he can fast without any fear. Fasting will prove to be very beneficial in his care. If weight is excess, then fasting weekly can help him largely. During fasting, lemon juice, tea or soup can be consumed.

INDIVIDUALS DEPENDENT ON MEDICINES:-

If doctor after complete check up of patient's condition and health has prescribed him biguanides and if patient takes only one dosage of prescribed medicine then he should not take it during the day of fasting. If in 24 hours patient takes 2 or more than 2 dose of medicine then during the day of fast, before the dinner time, he can take 1 dose. This will prove beneficial to him to control diabetes during fasting period.

If a person is on sulphonyl group of medicines and he controls his blood sugar through it then he can reduce the dosage of medicine to half during the fasting days. This dosage has to be taken before dinner time. If a patient is on long fasting like Navratri or Ramzan then he has to stop biguanides. Whereas, sulphonyl group of medicines can be taken but has to reduced to half the dose for first 3 days and then reduced to one fourth there by.

If one is on both biguanides and sulfonylureas group of medications then biguanides medicines have to be stopped and dose of sulfonylureas group of medications have to be reduced to half. This is because blood sugar level may fall suddenly if medicines are stopped completely and patient develop complications and he need to be admitted to the hospital.

There are certain patients who cannot control diabetes by oral medications and are prone to take insulin. They should not indulge in fasts in which intake of water is totally avoided. These patients should not even change the time table of their insulin intake. Even after such medical restrictions if patients want to keep fast they can fast but with certain precautions. Suppose, if weekly fast has to be kept then on the day of fast one third of the dose of insulin has to be taken in before dinner. Patient has to consult his doctor to know the correct amount of dosage he needs to take in during fasting days.

If one wants to fast for a longer duration against his doctor's recommendation then in such condition he should not take short-acting insulin. Long acting insulin should only be taken. Amount of insulin has to be reduced to half and should be taken before dinner. But, in case of many patients, changes have to be done in this aspect depending on their needs. Thus, it would be better if patient's consult their doctors before fasting. They should fast for the duration their doctor's recommend them and take insulin as per their recommended dosage.

Patients who are dependent on both insulin and sulfonylureas group or biguanides medicines are not allowed to take insulin and oral diabetic medicines at the same time. Now a days doctors are forced to give complex treatment in which insulin and oral diabetic medicines are given at the same time in order to control patient's blood glucose level. Such patient's need to fast to improve their present physical condition.

Even after all these complications, patient's are suggested that while practicing their rituals and customs they need not forget the characteristics of their disease. Along with this, diabetic patient have to take care of the following things:-

• Patients dependent on insulin should fast only after consulting their doctor. This will make sure that doctor need not face trouble during complicated condition of patient.
• Diabetic patient has to check his blood sugar level one day before fasting to know the effect on medicine on the control of blood sugar.
• If possible, during the day of fast too, blood sugar has to be checked to know it's level. This information is very useful to fast in the near future. 
• During the day of fast, urine glucose level has to be checked.
• During the day of fast, lemon juice, fat free soups, oranges etc..... can be consumed in small quantities.
• Uneasiness, dizziness, headache, sweat, slight shivering, increased heart beat, sensitivity of lips etc..... are experienced by diabetic patients when their blood glucose level fall from normal to low range. If any of these symptoms are experienced by diabetic patient then he should immediately consume any sweet fruit, juice or milk. He should not wait until condition worsens. He should also make his doctor aware regarding his condition.

In this way, diabetic patients by following precautions along with the suggestions of their consulting doctor can carry out their fasts carefully.