Living with Diabetes

Diabetes and Ramadan


About two billion Muslims around the world celebrate the holy month of Ramadan each year. It is the ninth month of the Muslim calendar and it is the month of fasting. Fasting is one of the five pillars of Islam and it is compulsory for every Muslim adult. 

Who should fast during Ramadan?

What are the exemptions from fasting?

Under certain circumstances, a few groups are exempt from fasting. However, they are required to make up the number of days missed later or give a certain amount of money to charity. People who fall under this category are listed below:

If I have Diabetes, can I fast?

You should discuss this with your healthcare team before making a decision. People with Diabetes are generally exempt from fasting because their condition may place them at high risk of various complications as their meal pattern, food quantity and fluid intake is markedly changed.
Fasting during Ramadan has been uniformly discouraged by the medical professionals for most people with Diabetes. However, people who have their condition under control, either by diet or using tablets, are at a lower risk of having complications. Some, may even benefit if a healthy diet is followed. It is important to know, however, that your healthcare team may need to make some changes to your medication regimen if you do take the decision to fast during this month.

People whose Diabetes is not adequately controlled and those who are taking insulin or other treatments that can increase the risk of hypoglycemia (low blood sugar levels) are advised not to fast due to the risk of complications.

Diabetes is a condition which varies significantly in its severity from one person to another. Hence, it is impossible to generalize about who should fast and who should not.

Hazards of fasting for people with Diabetes

Complications of fasting during Ramadan for people with Type 1 and Type 2 Diabetes are serious and can present multiple risks including hypoglycemia, hyperglycemia, dehydration, thrombosis, and diabetic ketoacidosis. For many people with Diabetes, managing complications is best accomplished by avoiding the fast completely.

The alteration of eating pattern without appropriate adjustment to the dosage and timing of insulin and/or oral medications may result in deterioration of glycemic (blood sugar) control and a higher risk of complications.

Furthermore, when Ramadan occurs during the summer months as is the case in Kuwait, prolonged fasting may create greater potential hazards. It is therefore important to discuss the management of Diabetes during Ramadan with your healthcare team.

Precautions for those who fast

The importance of continued compliance with dietary recommendations should be emphasized. Breaking the fast after sunset is not an excuse for over-eating and indulging!

You should avoid foods high in sugar and fats. You should also try to eat most of your carbohydrates at the pre-dawn meal as opposed to at the break of the fast later on during the day.

If you have Diabetes and you decide to fast. You should break your fast if the following occur:

Praying is a form of physical activity and should be taken into consideration as changes in physical activity can affect your blood sugar levels.

If you are fasting, be sure to monitor your blood sugar levels more frequently during the fast, including adjustment of medications as needed and work closely with your healthcare team. Testing your blood sugar levels will not break your fast.

Remember the following about Diabetes and Ramadan: