Diabetes and Fasting in Ramadan

Wednesday, June 15th, 2016

Fasting during Ramadan, a holy month of Islam, is a duty for all healthy adult Muslims. In patients who has diabetes metllitus type 1, are on multiple injections of insulin and are uncontrolled, fasting is associated with multiple risks. Fasting during Ramadan increases the risk of severe hypoglycemia (leading to hospitalization) 5-fold in patients with type 1 diabetes and 7-fold in patients with type 2 diabetes.

This year the fasting period is long – 13 hours in the UAE – meaning that the risks of low or high blood sugar levels and dehydration (lack of water) are high. The most crucial issue is the realization that care must be highly individualized and that the management plan will differ for each specific patient. It is essential that patients have the means to monitor their blood glucose levels multiple times daily.  During Ramadan there is a major change in the dietary pattern compared with other times of the year. Most health problems are likely to arise from inappropriate diet or as a consequence of over-eating and insufficient sleep. Therefore, the diet during Ramadan for people with diabetes should not differ significantly from a healthy and balanced diet. All patients should understand that they must end their fast if hypoglycemia occur (blood glucose of <60 mg/dl) or if blood glucose exceeds 300 mg/dl. All patients with diabetes should be seen by their physician 1-2 month prior to Ramadan, in order to assess the control of blood sugar and adjust the medications according to the period of fast.

By Dr. Sara El Ghandour

Specialist Internal Medicine, Endocrinology and Diabetes