Fasting is risky for people with diabetes and is not recommended for everyone. However, with advance consultation with a doctor and the right approach, some patients can get through Ramadan safely.
Can you fast if you have diabetes?
Whether a person with diabetes can fast depends on their health and treatment plan. People with type 2 diabetes may fast after their doctor has readjusted the doses of their medicines. Blood sugar must then be monitored closely, because the risk of a serious drop in blood sugar increases.
Fasting is generally not recommended for people with type 1 diabetes. They may develop high blood sugar, dangerous dehydration and deep vein thrombosis.
Who may find fasting risky?
In the following situations fasting can pose a serious health risk. If you belong to one of these groups, decide about fasting only together with your doctor:
- people whose blood sugar often drops below normal (under 60–70 mg/dl);
- people who do not feel hypoglycaemia – a drop in blood sugar;
- people with poorly controlled blood sugar;
- people who had a diabetic coma before Ramadan;
- people with type 1 diabetes;
- people with type 2 diabetes on insulin therapy;
- people with a stomach or duodenal ulcer;
- patients with chronic kidney failure or on dialysis;
- pregnant women with diabetes;
- people with diabetes who live alone and elderly patients.
How should you control your blood sugar?
Be sure to consult your doctor before you start fasting. If there are no general health obstacles, your doctor will adjust the dose and timing of your medicines to iftar and suhoor. Do not change the dose or timing of your medicines on your own.
Measure your blood sugar regularly on fasting days. Follow a proper diet and the treatment prescribed by your doctor to avoid high or low blood sugar. Keeping blood sugar under control is the most important thing while fasting.
It is useful to measure your sugar not only in the morning but during the day – especially in the afternoon and before iftar, and at any moment you feel unwell. After Ramadan ends, see your doctor again to return your medicines to their usual schedule.
How to eat at suhoor and iftar?
Protein increases the feeling of fullness and preserves muscle mass, while fibre supports digestion and reduces sudden spikes in blood sugar. Avoid sugary and fatty foods, and choose balanced, easily digestible meals. Healthy foods keep your energy level steady throughout the day, and balanced nutrition protects your hormones and metabolism, making the fast easier.
- at suhoor, eat eggs, milk, yoghurt, legumes and whole grains;
- at iftar, add fibre-rich foods such as vegetables, salads, legumes and nuts to your table;
- keep sweet and processed foods to a minimum – this way your blood sugar stays more stable;
- drink enough water between iftar and suhoor – dehydration is especially dangerous in diabetes.
The most suitable physical activity during Ramadan is walking. A 30–45 minute walk one to two hours after iftar helps digestion. You can also walk in the morning, a few hours after suhoor. If you plan to be active after iftar, avoid very fatty and heavy food; after the walk you can have a light snack. Strenuous workouts, on the other hand, cause extra fluid loss and can make fasting harder.
When should you break the fast?
Your health comes first. In the following situations you should break your fast immediately, measure your blood sugar and, if necessary, see a doctor:
- when blood sugar drops below 70 mg/dl;
- when signs of low blood sugar appear, such as trembling, cold sweat, palpitations, dizziness or confusion;
- when blood sugar rises above the limit set by your doctor;
- when there are signs of dehydration such as intense thirst, dry mouth, weakness, nausea or vomiting.
This article is for general information only and does not replace a medical examination.