This series of articles presents a focus on how Muslim Diabetic patients can remain well if they decide to fast during Ramadan.

Introduction

Every year, Muslims observe Ramadan, an important holy period.

Ramadan is about a month-long and usually involves a strict fasting regime for its adherents.

During the daily fast, they will neither eat or drink any fluids including water. They will generally break the fast twice in a day – before dawn and after sunset.

For Diabetic patients, the times before, during and after the fast are crucial to maintaining wellbeing.

We outline some key points about this here.

Section 1 – Before The Fast

Who Should Fast during Ramadan?

Some categories of people are exempted from fasting:

• Children younger than 12 years (or under the age of puberty);
• People who are ill (such as poorly controlled Diabetes or Diabetes with complications like Kidney Disease or Heart Disease;
• People with Learning Disability
• Travellers;
• Elderly people
• And menstruating, pregnant, or nursing women.

It is important (before the onset of Ramadan) to identify your health status especially as a Diabetic and take the appropriate decision.

This should be in conjunction with your clinician or diabetic specialist.

The reason for this includes the significant blood sugar changes that happen during the day (and for the entire period of Ramadan).

The changes occur as one engages in the cycle of food/drink restriction for a period, breaking of the fast; and resumption of fasting.

Thus, people may experience large swings in blood glucose levels due to the long gap between meals and larger amounts of food.

Section II – During The Fast

During Ramadan, healthy, well people are expected to abstain from food, drink – and oral medication from dawn to sunset.

The usual pattern therefore for meal taking during Ramadan is:

• Suhoor or Sehri (a meal before dawn)
• Fast period
• Iftar (a meal after sunset)
• Some snacking between iftar and the next suhoor (sehri) – after which the next fast period begins.

This can thus have a potential effect on the Diabetic patient – whether on Insulin or oral hypoglycaemic drugs.

In addition, the state of Diabetes control at the time is crucial.

If control is not very good, and an individual is prone to erratic blood sugar changes at all times of the day, they could become seriously ill when embarking on the fast.

The same thinking applies to someone who may have good sugar/ Diabetes control, but they are unwell with an infection like Malaria or a Urinary infection or Pneumonia.

All these (and other types of infections) can also skewer control of blood sugar.

Key Points – What should Muslim Diabetics Do before Fasting?

So to answer the question of who should fast: first engage with your physician directly beforehand to check your individual situation and that you are well.

If you are considered well enough, get the best advice for how to manage your blood sugar levels during the fast to prevent complications.

Also, you can learn what types of food will best suit optimal blood sugar control.

A discussion about your medication is also very important.

Some drugs may cause people to develop hypoglycaemia more than others (even in a stable diabetic person) and your doctor can help to identify this.

Muslim diabetics should be advised by their clerics to seek advice from their clinicians about their ability to fast safely during Ramadan.

(It’s also never too late to have that conversation with your doctor – even if you have already embarked on the fast).

If you are a clinician, have a look here at how you can risk-stratify your patients to help guide their decision about whether or not fasting is appropriate for them.

In part 2 of this series, we look at what happens during and after the fasting period and how people taking medication can keep as well as possible.

Read More:

• Risk Assessments for Muslim Diabetics at Ramadan
• Helping Muslim Diabetics remain well at Ramadan – Part 2
• Women’s Health Section
• Living with Diabetes – 9 recommended lifestyle changes
• Maintaining Your Heart Health

Edited by AskAwayHealth Team

Disclaimer

All AskAwayHealth articles are written by practising Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
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