Diabetes and Ramadan fasting
Many people with diabetes fast during Ramadan. Fasting can be safe for some and dangerous for others. This is a summary of the guidelines from the International Diabetes Federation (IDF) and the Diabetes and Ramadan (DAR) International Alliance.
Before Ramadan: see your doctor
The guidelines advise that everyone with diabetes who wants to fast has an assessment with their care team before Ramadan. Your doctor decides your risk level and adjusts the timing and doses of your medicines and insulin if needed.
Don't change your medicine or insulin doses on your own. Do it with your doctor.
When to break your fast straight away
- If your blood sugar is below 3.9 mmol/L (70 mg/dL).
- If your blood sugar is above 16.7 mmol/L (300 mg/dL).
- If you have symptoms of low blood sugar, or suddenly feel unwell.
If your reading is between 3.9 and 5.0 mmol/L, the guidelines say to check again within an hour.
Checking your blood sugar doesn't break the fast, and the guidelines encourage it while fasting.
Who is at higher risk?
The guidelines advise people at very high risk not to fast, for example:
- Severe low blood sugar or diabetic ketoacidosis (DKA) in the three months before Ramadan.
- Repeated lows, or not feeling the warning signs of a low.
- Poorly controlled type 1 diabetes.
- Pregnancy with diabetes needing insulin, dialysis, or an acute illness.
Your doctor decides where you fit. Some people are at moderate or low risk and can fast with monitoring.
What to ask your doctor
- Is fasting safe for me this year?
- How should I move my medicines between iftar and suhoor?
- How often should I check my blood sugar each day?
- What should I do if my sugar goes low or high while fasting?
Sources
- International Diabetes Federation and DAR International Alliance. Diabetes and Ramadan: Practical Guidelines (quick reference summary). Link