Fasting with Diabetes in Ramadan

3D Diabetes Stop Crossword on white background

Now that Ramadan is here, many people have a lot of questions regarding their health, and how fasting can affect their health in Ramadan.

One of the most common health concerns in Ramadan for diabetes patients is fasting.

I have diabetes; can I fast?

Many people with diabetes can fast safely, but each person is different. It is important to schedule an appointment with your doctor before Ramadan to discuss how fasting might affect your diabetes. Your doctor may suggest a change in your medication plan.

People with diabetes have been divided into high risk, moderate risk and low risk for problems with fasting as shown in the following table.





High Risk

Advised not to fast

·      Type 1 diabetes

·      If you use insulin injections more than two times a day

·      If you have poor control of your diabetes

·      If you have problems with frequent low blood sugar levels

·      If you have had a hospital admission within the last six months for very high or very low blood sugar levels

·      If you have low blood sugar levels with no symptoms

·      If you have problems with your kidneys, liver, heart or poor vision

·      If you have an acute illness, including a diabetic foot infection or foot ulcer

·      If you are pregnant

Moderate Risk

Do not fast unless agreed with doctor

·      If you have moderate control of your diabetes and no major complications of diabetes

·      Well-controlled diabetes with certain medications.

Low Risk

You should be able to fast with advice

·      Diabetes controlled with diet

·      Diabetes well controlled with certain medications.



What problems could I encounter in Ramadan with my diabetes?

These are the key risks:
• Low blood glucose – The risk of blood glucose levels becoming 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 doctor to find out if your medicine puts you at risk for low blood glucose and discuss how to prevent it.
• High blood glucose – 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

  • 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.

Is it okay to test my blood glucose in Ramadan while I am fasting?

Yes, checking blood glucose will not break a fast! Testing your blood glucose levels regularly is important and will keep you safe whilst fasting.

When do I have to break my fast?

You should immediately end your fast if blood glucose of  <60 mg/dl [3.3 mmol/l]) occurs because it may drop further if treatment was delayed.

You should also break fasting if blood glucose reaches <70 mg/dl (3.9 mmol/l) in the first few hours after the start of the fast, especially if insulin or some oral medications are taken at predawn.

Finally, the fast should be broken if blood glucose exceeds 300 mg/dl (16.7 mmol/l).

Do I stop taking medicine during Ramadan?

No. You continue taking your diabetes medicine, but you will take it at different times. Your dose may also change. This is why it is very important to talk with your doctor before Ramadan so you can plan ahead for how your diabetes medicines may need to change.

In the end, we would like to wish a happy, healthy and safe Ramadan for you and your whole family.

This article was brought to you by Tabibi 24/7, Cairo’s leading family medicine & pediatrics group practice. Tabibi operates 24/7 and offers its services in the comfort of your own home or in one of its clinics.

For more information, you can call 16724.

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