Fasting during Ramadan

What is fasting during Ramadan?

Fasting (or "Sawm") is one of the 5 pillars or obligations of Islam. During the month of Ramadan, Muslims are obligated to fast everyday between sunrise and sunset. Fasting means they cannot consume and food or drink or even take medication during this period.

Healthy Muslims without diabetes can fast whilst continuing with their usual daily routines and will perform extra prayers, good deeds and spend more time with family and friends. It is seen as a time for helping others, coming together as a community, spiritual reflection and purification.

However, it is important to know that some people are not obligated to fast:

  • Children (under the age of puberty)
  • Older people
  • If you are sick
  • Those with learning difficulties
  • Those with mental health problems
  • Anyone who is putting their health at risk by fasting (people with diabetes can fall into this category)

People who cannot fast at all often contribute by providing food for others or making donations to people less fortunate (called "Fidya"). Some people can postpone their fasting until a later date (called "Qadha") for the following reasons:

  • If you are pregnant or breastfeeding
  • If you are menstruating
  • If you are travelling more than 57.5 miles each day where fasting is difficult

I have type 1 diabetes - can I fast?

People with type 1 diabetes are at very high risk of fasting-related complications. The biggest risk is hypoglycaemia ("hypo"), which is more important if you have no hypoglycaemic awareness, or you have had severe hypo or recurrent hypoglycaemic episodes the three months leading into Ramadan. This would put your health at risk, and therefore you are not obligated to fast.

If you have type 1 diabetes and decide that you still want to fast, it is important to talk to your diabetes team so that you can talk about ways to keep you safe while fasting. There are some important things to consider:

  • Even though you are not eating or drinking, it is a good idea to check your blood glucose levels regularly when you are fasting. Checking your blood glucose levels does not break your fast.
  • If your blood glucose level is less than 4mmol/L (a hypo) you will have to end your fast by treating the hypo.
  • You may need to reduce your basal insulin (e.g. levemir, lantus or tresiba) dose whilst fasting in order to reduce your chances of having a hypoglycaemic episode.
  • If you have an insulin pump, it is easier to fast as your basal insulin very adjustable. Speak with your diabetes team so that you can talk about the best way to adjust your basal insulin profile.

I have type 2 diabetes - can I fast?

People with type 2 diabetes who manage their diabetes with diet alone (i.e. they take no medicine) can fast safely without the risk of having a hypo. Some choose to use this time to make healthy changes to their diet and lifestyle. Speak to your dietitian if you would like more information on healthy eating and exercise.

If you have type 2 diabetes and are taking any medication (e.g. metformin) speak to your diabetes team so that you can talk about the best times to take your medication without interrupting your fast.

More information on Ramadan fasting can be found on the Diabetes UK website.