Do you have diabetes and are planning on fasting during Ramadan? There can be so much excitement to fast during Ramadan. You may have a strong desire to fast during Ramadan to reap the blessings and partake in the community spirit. However, before you start fasting during Ramadan it’s important to consider the following to keep you healthy and safe.

1) Talk to your healthcare provider

It’s important to let your healthcare provider and diabetes team know if you are planning on fasting during Ramadan. Your healthcare provider can assess your risk for fasting and may need to adjust your medications accordingly. Telling your healthcare provider does not mean that you won’t be able to fast! It just means that you will learn about any risks for fasting and how to do so safely.

2) Know your health risks

Some people with diabetes can fast safely during Ramadan, however others may be at risk. Your risks for fasting may include

  • Low blood sugar (hypoglycemia)
  • High blood sugar (hyperglycemia)
  • Dehydration and diabetic ketoacidosis (DKA)

Certain medications may increase your risk for low blood sugars. Talk to your doctor to identify your risks for fasting in order to take precautions and minimize health risks.

3) Take your medications

It’s important that you let your doctor know if you are planning on fasting as your medications may need to be adjusted. Take your medications according to the prescribed times to prevent blood sugar fluctuations.

4) Monitor your blood sugars

Pricking your fingers to check your blood sugars does not break your fast. It is important to monitor your blood sugars to prevent dangerous lows or highs. Symptoms of low and high blood sugars are not always accurate and some people may not have blood sugar symptoms at all. The only way to assess the effect of the fast on your blood sugars is to monitor your blood sugars with a blood glucose meter. Speak to your diabetes educator to learn more about the timing and frequency of checking your blood sugars.

Concept diabetes in the elderly retired. Senior man with glucometer checking blood sugar level at home. Learn to use a glucometer

5) Know when to break your fast

If your blood sugars are in dangerous low or high levels, you need to break your fast to avoid life threatening conditions. Always and immediately end the fast if:

  • hypoglycemia occurs (blood glucose of <60 mg/dl [3.3 mmol/l]
  • blood glucose reaches <70 mg/dl (3.9 mmol/l) in the first few hours after the start of the fast, especially if insulin, sulfonylurea drugs, or meglitinide are taken at predawn
  • blood glucose exceeds 300 mg/dl (16.7 mmol/l)
  • avoid fasting on “sick days”

If your blood sugar is less than 70 mg/dL (3.9 mmol/L), treat your blood sugar using one of the following:

  • Chew four Dex 4 glucose tablets
  • Drink ¾ c regular pop or ½ c juice
  • Take 1 tablespoon of honey or sugar

Check your blood sugars again in 15 minutes to make sure it’s higher than 70 mg/dL (4 mmol/L).

5) Focus on eating balanced meals

A balanced meal means that it contains a combination of carbohydrates, protein, and healthy fats. This combination of nutrients is important to help you balance your blood sugars and keep you full and satisfied at iftar, suhur, and snack.

Carbohydrate foods include whole wheat pita, naan, rice, corn, potato, oats.

Protein foods include eggs, nuts, fish, meat, cheese, beans, lentils.

Fats include cooking oils, butter, ghee, avocados, nuts, olives, salad dressings.

A great method to balance your meals is to follow the healthy plate method: of your plate is for non- starchy vegetables (eg. salad, cooked vegetables)

  • ½ of your plate is for non- starchy vegetables (eg. salad, cooked vegetables)
  • ¼ plate for whole grains or starchy vegetables
  • ¼ plate for proteins
healthy plate model

It is also very important to eat your suhur (pre-dawn meal) as close as possible to dawn to help you manage your blood sugars. For healthy suhur ideas you can check out this blog post.

south asian food naan

6) Hydrate your body

Fasting for long hours especially in the summer months can dehydrate your body. Remember to drink enough water and fluids during the non-fasting hours to hydrate your body sufficiently. Be mindful of sugary beverages and fruit juices which can cause high blood sugars. You can include hydrating foods with your meals and snack, such as cucumbers, watermelon, strawberries, zucchini, and tomatoes.

7) Move your body

Exercise is an important part of managing your diabetes. During Ramadan exercise may be maintained. However, avoid excessive exercise especially during the few hours before sunset as this increases your risk for low blood sugars. Also, the nightly taraweeh prayers can be considered part of exercise.

8) Follow up with your healthcare team after Ramadan

After Ramadan is over, it is important that you follow up with your healthcare provider to review your Ramadan experience which will help prepare you for next year’s Ramadan. Your medications might also be adjusted to  your earlier medication schedule.

Bottom line: Fasting with Diabetes

Diabetes is different for each person. Talk to your healthcare provider and diabetes team and dietitian to learn about your health risks and if you can fast safely during Ramadan. This step is important to help you have a spiritually uplifting and safe Ramadan.

You can also check the following Ramadan blog posts:

If you would like support on managing your diabetes during Ramadan, please schedule a free discovery call with me to learn how I can support you.

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