Ramadan and diabetes

If you’ve got diabetes you need to be ready for Ramadan. Fasting when you’ve got diabetes, especially for such long periods, can be dangerous and cause problems for your health.
If you want to fast during Ramadan make sure you speak to your diabetes team so they can help you decide if it’s safe to do so. If they’re happy for you to fast they’ll be able to help you manage your diabetes through Ramadan.

What happens to my body when I fast?

When we fast, at about eight hours after our last meal, our bodies start to use energy stores to keep our blood glucose levels normal. For most people, this is not harmful.

If you have diabetes, especially if you take certain tablets or insulin, you’re at risk of hypoglycemia (or hypos for short) which is when your blood sugars are too low. With this year’s long fasts the risks of hypos and dehydration are high. Another problem that can occur, is the risk of high glucose levels following the larger meals that we eat before and after fasting at Suhoor (Sehri) and Iftar.
Hypos, high glucose levels, and dehydration can be dangerous for people with diabetes.

I have diabetes – can I fast?

We know that choosing to fast is a very personal decision. For some people with diabetes, fasting can be dangerous or cause problems for your health. People with certain health conditions like diabetes are exempt from fasting, especially if they use insulin or certain other medications. The same goes for anyone who has poor control of their diabetes or complications caused by diabetes like foot problems or damage to their kidneys or eyes.

If you do want to fast make sure you speak to your GP, diabetes nurse or diabetes doctor before Ramadan starts.
People can also be exempt from fasting if they:

• are children (under the age of puberty)
• are elderly
• are sick or have a certain health condition
• have learning difficulties
• are traveling
• are pregnant, breastfeeding or menstruating.

If you can’t fast

If you’re not able to fast, you can complete your duties by offering charity or providing food to the poor. Speak to your local Imam for more information about this. If you can’t fast this Ramadan, you might be able to make up the fast at a later date, perhaps during the winter months.

Test your blood during the fast

It’s really important to regularly test your blood glucose levels during your fast so you can check you’re keeping safe. This will not break your fast.

Do I need to wake up for Suhoor (Sehri)?

Long hours without eating increase the risk of hypoglycemia. It will be easier to balance your blood glucose levels through the fast if you eat a meal at Suhoor, just before sunrise, rather than at midnight.

What types of food should I eat at Suhoor (Sehri)?

At Suhoor you should eat starchy carbohydrates that release energy slowly, such as multigrain bread, oat-based cereals, basmati rice together with beans, pulses, lentils and fruit and vegetables. Other foods that will keep your blood glucose levels more stable through the fast include pitta bread, chapattis and semolina. As with all meals, eat sensibly, don’t overeat and remember to drink plenty of water.

What types of food should I eat at Iftar?

Remember to eat sensibly and healthily all year round but also in Ramadan. Eating too much-fried food and food high in fat and sugar will make you put on weight and raise your blood sugar levels and make them more difficult to control. Try to eat moderate portion sizes. Remember that Ramadan is also about self-control and discipline. If you have diabetes you can ask to see a dietitian who’ll be able to give you more advice about healthy eating.

What types of drinks can I have?

Fasting can put you at risk of dehydration with long hours of fasting and also if you have high blood
glucose levels. Drink plenty of sugar-free fluids, particularly water at Suhoor and after Iftar.

Can I pray Taraweeh?

Taraweeh can be a tiring activity and you could become dehydrated or be at risk of hypos.
To avoid problems during Taraweeh, make sure you:
• eat starchy foods with Iftar as they are digested slowly
• drink plenty of water following Iftar
• take a bottle of water and glucose treatment with you to Taraweeh.

Keeping safe

• Always carry glucose treatment with you.
• Always have diabetes identification, such as a medical bracelet.
• Test your blood regularly to monitor your glucose levels. This will not break your fast.
• Test your blood glucose level if you feel unwell during the fast.
• If your blood sugar level is high or low, you must treat this.
• If your blood glucose is less than 4.0mmol/l, end the fast immediately and treat the low blood sugar level.
• If your blood glucose level is below 4.0mmol/l at the start of the fast and you are on insulin or sulphonylureas (or any other medication that can cause a hypo), don’t fast and treat your hypo right away.
• If your blood glucose level is higher than 16.7mmol/l, end the fast immediately.
• If you become dehydrated, end the fast immediately and have a drink of water.
• If you start to feel unwell, disoriented, confused, if you collapse or faint, stop fasting and have a drink of water or other fluid.
• You should never stop your insulin, but you must speak to your doctor because you may need to change the dose and times of your insulin injections.
• If any of this happens, speak to your diabetes team before fasting again.

Quick tips

• Speak to your diabetes team if you’re planning to fast.
• Check your blood glucose levels more often.
• Try to fast a couple of days in the month before Ramadan to see if you’re capable of fasting without complications.
• Continue a varied and balanced diet.
• Include more starchy carbohydrates and slowly absorbed foods.
• Try not to have too many sugary and fatty foods.
• When you break the fast, make sure you drink plenty of sugar-free and decaffeinated drinks to avoid dehydration.

What is diabetes?

• Diabetes is a health condition where the amount of glucose in your blood gets too high.
• This happens if your pancreas doesn’t make any insulin or enough insulin to help the glucose enter your body’s cells. Or the insulin it does make doesn’t work properly.
• Insulin is the hormone produced by the pancreas that allows glucose to enter the body’s cells, where it’s used as fuel for energy so we can work, play and generally live our lives. It’s vital for life.
• Glucose comes from digesting carbohydrate and it’s also produced by the liver.
• If you have diabetes, your body cannot make proper use of this fuel so it builds up in the blood
which can be dangerous. There are two types of diabetes

Type 1
• Type 1 is when the body is unable to produce any insulin, which we need to break down the glucose (energy) in what we eat or drink.
• We don’t know exactly what causes it, but we know it’s not to do with being overweight. You can’t prevent Type 1 diabetes.
• It is usually diagnosed when you’re a child or young adult, although it can occur in older adults as well.
• Approximately 10 percent of people with diabetes have Type 1.

Type 2
• Type 2 develops when the body cannot make enough insulin, or when the insulin produced doesn’t work properly.
• Your family history, age, and ethnic background affects your risk of developing it, and you’re more likely to get Type 2 diabetes if you’re overweight.
• It starts gradually, usually later in life, and because the symptoms may not be so obvious it might be years before you learn that you have it.
• If undetected can lead to serious life-threatening conditions.
• Approximately 90 percent of people living with diabetes have Type 2.
• Speak to your diabetes team if you’re planning to fast.
• Check your blood glucose levels more often.
• Try to fast a couple of days in the month before Ramadan to see if you’re capable of fasting without complications.
• Continue a varied and balanced diet.
• Include more starchy carbohydrates and slowly absorbed foods.
• Try not to have too many sugary and fatty foods.
• When you break the fast, make sure you drink plenty of sugar-free and decaffeinated drinks to avoid dehydration.