Always consult your doctor before going for a fast of any duration.

What risks you should be aware of?  

These are the key risks:

• Low blood glucose (or hypoglycaemia) - Limit physical activity during fasting hours. Talk to your healthcare provider to find out if your medicine puts you at risk of low blood glucose and discuss how to prevent it.
• High blood glucose (or hyperglycaemia) - while low blood glucose levels may happen during fasting,once the fast is broken, there is a greater risk of  overeating. Watch out for eating too many sweets and keep the portion sizes moderate.
• Dehydration- This is especially a problem during the longer and hotter  summer days. Aim to drink sugar free and caffeine free drinks frequently throughout the fast.

Checking blood sugar during fasting

Checking blood  glucose will not break a fast! It is important  to monitor blood  glucose levels especially to identify low glucose levels. A fast will have to be ended if glucose levels faII too low (below 70mg/dL)

How is low blood glucose treated?

If glucose  levels do  fall  below  70  mg/dl, take 15 grams of carbohydrate in the form of one of these: 4 glucose tablets, 6 oz regular soda, 4 oz fruit juice or 1 tube glucose gel. Wait for 15 minutes and check your blood glucose levels again.

http://www.joslin.org/info/how_to_treat_a_low_blood_glucose.html

Planning ahead

• Choose a restaurant with a large menu of healthy items.
• Have a small snack before  going to a restaurant, so you aren't too hungry.

Tips on ordering meals with diabetes

• If you are not sure how a particular dish is prepared,ask the server.
• Watch your portion sizes. Order an appetizer for the main course, split an entree, or eat half and take the rest home.
• Ask for substitutions. For example, opt for vegetables instead of french fries.
• Avoid breaded items, fried foods or foods with heavy sauces. Try fish  or poultry that is grilied or boiled,without butter.

Follow some easy steps to handle diabetes at your work place.

• Try to take your medicine on time even when you have extended hours of work.
• It is always good to have your glucose monitoring  device along with you on the job.
• When you have diabetes,never skip or delay breakfast. Skipping or delaying breakfast can lead to dangerously low sugar levels especially when you have taken medicine.
• Eating at regular intervals is very essential for management  of diabetes.Try to eat at your usual time.
• It is important that at least one person in your work place knows of your condition, particularly if you are using insulin. Give him/her a short description of what diabetes is and what may happen when blood sugars drop too low and how to help you.

With  low  blood  sugar (hypoglycaemia). you  may feel  shaky, fast heartbeat,  sweaty,  anxious,   dizzy, hungry,   blurred  vision,  weak, fatigue,headache,or irritable.

If you have any symptoms of low blood sugar, check your blood sugar immediately. If low, eat or drink a sugary food,such as:

•  4 ounces (1/2 cup) of regular fruit juice (such as orange, apple or grape juice).
•  4 ounces(1/2 cup) of regular soda pop (not diet).
•  3 glucose tablets.
•  5 to 6 hard candies that you can chew quickly (such as mints).

Wait for 15 minutes and then check your blood sugar again. If it is still low,eat or drink a sugary food again. Once your blood sugar returns to normal, eat a meal or snack.This can prevent your further low sugars.

Uncontrolled diabetes can lead to sexual problems in both men and women. Tests can be done to discover if diabetes has caused damage to your nervous system or blood vessels that is affecting your sex life.If you feel that diabetes is causing problems in your sex life, talk to your doctor.

Issues in men :

Men may have difficulty with erections or ejaculation. Erectile dysfunction is a condition that affects a man's ability to get and sustain an erection that leads to positive sexual experiences.
Retrograde ejaculation is a condition in which part or all of a man's semen goes into the bladder instead of coming out from the tip of the penis during ejaculation.

Solution :

If erectile dysfunction is a concern,make sure to discuss your medications with your  doctor, as some medications can lead  to erectile dysfunction. Sometimes different medications can be prescribed that don't have erectile dysfunction as a side effect.

Retrograde ejaculation caused by diabetes may be helped with a medication that strengthens the muscle tone of the sphincter in the bladder. Check with your doctor before  taking any medicine or herbal medication.

Plan your travel to be comfortable and safe. Follow these tips for a comfortable trip:

• Always carry your diabetes supplies with you (in handbag or in a place easily accessible). Don't forget to include the prescription letter items such as blood glucose testing equipment and syringes.
• Try to keep your insulin in a cool, dark place.
• Travelling abroad with diabetes: Carry enough insulin with you. Keep track of your insulin shots and meals through changing time zones. In different countries insulin of different strengths is available like U-100 or U-40. If you need to use these insulins, you must buy new syringes to match the new insulin to avoid a mistake in your insulin dose. U-100 insulin should be taken with U-100 syringe.
• Carry along good amount of supply of glucose/ sugar/ hard candies to treat hypoglycaemia.
• Always carry some dry snacks like biscuits in your handbag.
• Check your blood glucose more frequently while traveling. Also, check your blood glucose level as soon as possible after landing.

Packing Checklist

• lnsulins,syringes,blood glucose meter,test strips,lancets.
• Prescriptions for medications and testing supplies.
• Things for taking care of hypoglycaemia.
• Non-perishable snacks like biscuits.
• First-aid medications which  includes band-aid, antiseptic cream,cotton,gauze pieces and soap.

There are two aspects of diabetes during pregnancy.

• Gestational diabetes occurs when a woman is pregnant. Post the baby's birth, it usually goes away, but it does increase your risk of having diabetes later.
• Gestational diabetes mellitus accounts for 90% of cases of diabetes mellitus in pregnancy.
  http://emedicine.medscape.com/article/127547-overview
  The rest accounts for women who had diabetes diagnosed that was present before pregnancy.
• Rest accounts for women who had diabetes diagnosed that was present before pregnancy. Women can have either of type 1 or type 2 diabetes.

Few key notes

• Women with diabetes must go for renal assessment and eye fundus examination.
• If you already have diabetes and are planning to have a baby, it is desirable to achieve and maintain blood sugar control for at least three months before you plan to get pregnant.
• Instead of three large meals a day,split your daily food into  six smaller ones, regularly spaced andcarefully planned. Snacks will be important, and should probably include a complex carbohydrate (such as whole­grain bread)  and a protein (such as sprouts and paneer).
• It is very important not to skip meals or snacks, since that can lower blood glucose to dangerous levels.
• Overweight women should lose weight through exercise. Check with your doctor about your planned activity and startslowly.
• Your insulin dose may have to be adjusted upward periodically because of interference of pregnancy hormones with activity of insulin.
• Monitor your blood glucose levels at least 4 times a day.

• If you had gestational diabetes,you should at least test for diabetes for 6-12 weeks after you give birth to your child,even if the result is normal.
• Whenever you are planning for another pregnancy, be sure to tell any health care providers that you have had gestational diabetes before.
• Go for regular screening of type 2 diabetes.
• If you had diabetes before pregnancy you will be able to go back to your pre-pregnancy insulin dosage very soon after birth. Go for your reguIar check-ups with your doctor.
• Breast feeding is great for babies,as well as women with diabetes as it lowers the amount of insulin you need.  

Introduction:

Any kind of sickness- simple ones like cold, flu, sore throat, and infections of ear,teeth or bladder,vomiting or diarrhea or more serious ones like pneumonia or a foot infection affects diabetes in many ways.This means that diabetes is more difficult to control when one is sick.

Four main concerns and their preventive action