Ramadan Fasting with Diabetes

By Nazirber De La Cruz

Ramadan Fasting with Diabetes

Ramadan is a sacred month for the Muslim community which celebrates when the gates of heaven are open wider than ever and the Prophet Muhammad received the first revelation of the Quran, the holy book for Muslims. Ramadan has cultural, religious, moral, and mental significance for those who observe it.

Muslims fast with the intention of getting closer to Allah, purify the body, and emphasize the suffering of those less fortunate. During this time families gather to pray, fast and send a message of equality to society. In 2019, the holy month of Islam falls on May 5th through June 5th.

Fasting during Ramadan

Ramadan fasting is different from typical intermittent fasting where people fast for 12, 16 or 24 hours at any time. Muslims around the world fast for thirty days from dawn to dusk. Where in the world the person is located will determine how long the fast will last.

Ramadan fasting includes no food, drink, oral medications, sexual intercourse, and smoking for the entire period of the fast. Depending on the length of the eating window, many eat only two meals: one before dawn called Suhur and one after sunset called Iftar. The geographical location and season can make the fast last from a few hours to more than 20 hours.

People with Diabetes can be exempt from fasting

Fasting is a mandatory duty for healthy Muslim adults. However, the Quran exempts people with chronic medical conditions from fasting, especially if their health is at risk. Therefore, people with diabetes are exempt from fasting.

One of the complications of fasting when having diabetes is the abstinence of medication while fasting. It is essential to speak to your health care provider to figure out a plan to take your medication and still honor your traditions.

Fasting for someone with diabetes poses great challenges both for the person and their health care team, and it should be a personal decision made with medical guidance.

Other people who can be exempt from Ramadan fasting include: 
  • Pregnant women
  • Menstruating women
  • Breastfeeding women
  • Individuals living with chronic or short-term medical conditions
  • Children
  • Individuals traveling

When to “break” the fasting

Talking to a Certified Diabetes Educator and physician before Ramadan will ensure the diabetic person gets an individualized plan with strategies to make it safe.

People with diabetes should interrupt Ramadan fasting if they have any of the following:

  • Hypoglycemia (blood glucose less than 70 mg/dL)
  • Hyperglycemia (blood glucose more than 300 mg/dL)
  • During “sick days” or when not feeling well

Recommendations for fasting during Ramadan:

Hydration: Drink plenty of non-sugary drinks after sundown to stay hydrated during the fast.

Check blood sugars regularly: It is important to check blood glucose more frequently during fasting to ensure blood sugar does not go too low or high. It is recommended to check 2-3 times per day when fasting.

Meal planning: Meals during Ramadan should not be different from regular days and should be balanced with carbohydrates, proteins, and fats. The traditional last meal that ends at dawn called Iftar, followed by dates and water, should be in moderation with combinations of whole grains and lean proteins such as fish or poultry.

Tip: Try adding breakfast as late a possible before initiating fasting to feel more satiated during the fast. An example of a healthy breakfast is whole grain Roti with eggs and dates.

Schedule a health care visit: Make an appointment with your doctor and Certified Diabetes Educator 2-3 months before Ramadan starts to create a plan for your medications and overall diabetes management.

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Orignially published on April 5, 2019, updated on April 18, 2019

Topic: Nutrition

Nazirber De La Cruz

About Nazirber De La Cruz

Nazirber De La Cruz, RDN, CDN, CDE, is a bilingual Registered Dietitian Nutritionist and Certified Diabetes Educator. She graduated from the City University of New York in 2011 and completed her integrative medicine fellowship and became a Certified Diabetes Educator in 2018. Follow her on Instagram at @myfitbytes, on LinkedIn at linkedin.com/in/nazirberdelacruz and on her website www.myfitbytes.com.