Health and Me

Rachel V Thomas

Diabetic but planning to fast during Ramzan? Here's what to keep in mind

Diabetic but planning to fast during Ramzan? Here's what to keep in mind

<span>Ramzan</span>, the holiest month in Islam, marked by dawn-to-dusk fasting, poses health risks for people with <span><a href="https://www.healthandme.com/health/diabetes">diabetes</a></span>. Health experts urge patients to consult their doctors before observing the fast.

Ramzan is a period of intense spiritual reflection, self-discipline, and devotion for Muslims worldwide. During the month-long fasting period, the believers refrain from eating and even drinking (including water), from dawn to sunset.

The faithful eat a modest meal (sehri) before the first light of dawn to provide energy for the day. The fast is broken at sunset, traditionally starting with dates and water, followed by a larger meal (iftar).

According to health experts, for individuals whose diabetes is well controlled, fasting may be possible with proper adjustments.

"Diabetes requires regular monitoring, balanced meals, and timely medication. When eating patterns change during Ramzan, blood <span>glucose</span> levels can fluctuate. That is why I strongly recommend consulting your doctor before you plan to fast,” Dr. Saptarshi Bhattacharya, Senior Consultant, Endocrinology, Indraprastha Apollo Hospitals, told HealthandMe.

The expert advised people not to skip sehri, and to include complex carbohydrates such as whole grains, along with protein like eggs, dal, or curd, and plenty of fluids to help maintain stable glucose levels throughout the day.

At iftar, avoid overeating. Start with light, balanced food and limit fried items, sweets, and sugary drinks, as these can cause a sudden spike in blood glucose, Dr. Bhattacharya said.

Type 2 Diabetes patients with good glycemic control, lifestyle management, or stable oral medications can fast safely.

However, those on multiple <span>insulin</span> doses, with complications, or with poor control are considered moderate to high risk, Dr. Kartik Thakkar, Consultant Medicine, Ruby Hall Clinic, told HealthandMe. 

The health expert also noted that most Type 1 diabetes patients are considered high risk, especially those with brittle diabetes, frequent hypoglycemia (low <span>blood sugar</span>), or a history of diabetic ketoacidosis (DKA). Many are medically advised not to fast, particularly if glucose control is unstable. 

Children and adolescents with type 1 diabetes are considered high risk and are usually advised against fasting due to the unpredictable nature of insulin requirements. 

<h2>Who Should Avoid Fasting Altogether? </h2>

<ul><li>People with a history of severe hypoglycemia in the last 3 months; </li><li>Recurrent hypoglycemia; </li><li>Advanced kidney disease; </li><li>Elderly patients with frailty; and</li><li>Pregnant women with diabetes</li></ul> 

Dr. Thakkar said that such individuals fall into the very high-risk category and are medically exempt from fasting. 

The expert also suggested clinical tests to determine whether a diabetic patient is fit to fast. These include: 

<ul><li>Glycemic control (<span rel="noindex">HbA1c</span> levels) </li><li>Duration of diabetes (long-standing diabetes can increase complication risk) </li><li>Presence of complications (neuropathy, nephropathy, cardiovascular disease) </li><li>Kidney function and hydration status</li></ul>

<h2>What Warning Signs Should Prompt Breaking The Fast Immediately? </h2>

A diabetic patient must break the fast if: 

<ul><li>Blood glucose &lt;70 mg/dL (3.9 mmol/L) </li><li>Blood glucose &gt;300 mg/dL (16.7 mmol/L) </li><li>Severe dizziness or fainting </li><li>Confusion or blurred vision </li><li>Persistent vomiting </li><li>Symptoms of dehydration (extreme thirst, very low urine output) </li><li>Chest pain or breathlessness</li></ul>

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Ramzan, the holiest month in Islam, marked by dawn-to-dusk fasting, poses health risks for people with diabetes. Health experts urge patients to consult their doctors before observing the fast.Ramzan is a period of intense spiritual reflection, self-discipline, and devotion for Muslims worldwide. During the month-long fasting period, the believers refrain from eating and even drinking (including water), from dawn to sunset.The faithful eat a modest meal (sehri) before the first light of dawn to provide energy for the day. The fast is broken at sunset, traditionally starting with dates and water, followed by a larger meal (iftar). According to health experts, for individuals whose diabetes is well controlled, fasting may be possible with proper adjustments."Diabetes requires regular monitoring, balanced meals, and timely medication. When eating patterns change during Ramzan, blood glucose levels can fluctuate. That is why I strongly recommend consulting your doctor before you plan to fast,” Dr. Saptarshi Bhattacharya, Senior Consultant, Endocrinology, Indraprastha Apollo Hospitals, told HealthandMe.The expert advised people not to skip sehri, and to include complex carbohydrates such as whole grains, along with protein like eggs, dal, or curd, and plenty of fluids to help maintain stable glucose levels throughout the day.At iftar, avoid overeating. Start with light, balanced food and limit fried items, sweets, and sugary drinks, as these can cause a sudden spike in blood glucose, Dr. Bhattacharya said.Type 2 Diabetes patients with good glycemic control, lifestyle management, or stable oral medications can fast safely.However, those on multiple insulin doses, with complications, or with poor control are considered moderate to high risk, Dr. Kartik Thakkar, Consultant Medicine, Ruby Hall Clinic, told HealthandMe. The health expert also noted that most Type 1 diabetes patients are considered high risk, especially those with brittle diabetes, frequent hypoglycemia (low blood sugar), or a history of diabetic ketoacidosis (DKA). Many are medically advised not to fast, particularly if glucose control is unstable. Children and adolescents with type 1 diabetes are considered high risk and are usually advised against fasting due to the unpredictable nature of insulin requirements. Who Should Avoid Fasting Altogether? People with a history of severe hypoglycemia in the last 3 months; Recurrent hypoglycemia; Advanced kidney disease; Elderly patients with frailty; andPregnant women with diabetes Dr. Thakkar said that such individuals fall into the very high-risk category and are medically exempt from fasting. The expert also suggested clinical tests to determine whether a diabetic patient is fit to fast. These include: Glycemic control (HbA1c levels) Duration of diabetes (long-standing diabetes can increase complication risk) Presence of complications (neuropathy, nephropathy, cardiovascular disease) Kidney function and hydration statusWhat Warning Signs Should Prompt Breaking The Fast Immediately?  A diabetic patient must break the fast if: Blood glucose Blood glucose >300 mg/dL (16.7 mmol/L) Severe dizziness or fainting Confusion or blurred vision Persistent vomiting Symptoms of dehydration (extreme thirst, very low urine output) Chest pain or breathlessness