Fasting during the holy month of Ramadan is an important spiritual practice. When you have diabetes, you may be wondering how fasting will affect your diabetes. There is a lot of misinformation about diabetes and Ramadan. Here are some answers to some of the most common questions.
Does everyone have to fast?
No. This is based on the Holy Quran as well as the teachings of Islamic religious scholars over centuries. The Quran states that there are groups of people who do not have to fast, especially if it puts their health at risk. This includes children, pregnant or breastfeeding women, the elderly and anyone who might make themselves ill by fasting. This also includes people with poorly controlled diabetes, people with type 1 diabetes who take insulin or type 2 on a mixed insulin regimen or those who often have very high or very low blood glucose levels.
I know many people with diabetes who fast and don’t have a problem. Is it okay for me?
It is true, many people with diabetes can fast safely, but each person is different. Part of the decision you will make with your doctor has to do with the kind of diabetes medicine you take. It is important to schedule an appointment 2-3 months before Ramadan to discuss how fasting might affect your diabetes. Your doctor or healthcare provider may suggest a change in your medication plan.
What risks should I be aware of?
These are the key risks:
• Low blood glucose (or hypoglycemia) – The risk of blood glucose levels going too low is highest in people taking insulin or certain diabetes pills. Limit physical activity during fasting hours and be more active after sunset. Talk with your healthcare provider to find out if your medicine puts you at risk for low blood glucose and discuss how to prevent it.
• High blood glucose (or hyperglycemia) – While low blood glucose levels may happen during the day, after the fast is broken, there is a greater risk to overeat. Watch out for eating too many sweets and keep the portion sizes moderate. Even though Ramadan is known as a time of fasting – it is not uncommon for people to gain weight during this month, as in some families, every evening meal is a celebration.
• 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 evening and before dawn.
For healthcare professionals, please refer to the updated guidelines for Ramadan and diabetes.