Just a few days back, I was walking down a lane when I came across a person who fainted and fell before me. I got curious and learned that the man was fasting and he had recently been diagnosed with diabetes. He was given immediate medical support and revived.

This incident primarily occurred because he was unaware about the disease. He fell unconscious because the blood glucose levels of his body spiked up while fasting due to the change in medical timings and improper meals. It got me thinking if it is really safe for a diabetic to fast during Ramadan.

What Is Diabetes?

To keep it short, Diabetes is a condition where the blood sugar level is high due to the lack of Insulin – a hormone produced by the Pancreas. Insulin converts glucose into energy and supplies it to every single cell present in the body. The 3 main type of Diabetes include Type 1, Type 2 and Gestational.

In Type 1, the Pancreas stop working and in Type 2, the body produces a little Insulin or does not use it properly. This results in several health problems. Gestational Diabetes often occurs during pregnancy and it generally goes away after delivery.

Should You Fast During Ramadan If You’re Diabetic? 

During this holy month, the Muslim community observes a fast, eating only before sunrise (Suhoor) and after sunset (Iftar). They are not allowed to eat or drink anything in between. However, there is an exception towards people with medical ailments.

Diabetics and those at lower or moderate risks may choose to fast but there certainly isn’t a choice for those at higher risks. If you do choose to fast, keep an eye over blood sugar levels throughout the day. Most importantly, consult a doctor before fasting to avoid medical emergencies.

What Happens To Diabetics When They Fast?

Monitoring your blood glucose level while fasting is crucial for a diabetic. When healthy individuals consume food, Insulin is released by the Pancreas and it stores Glucose in the Liver and Glycogen in the Muscles which balance out the Blood Glucose Levels and maintain it at optimal range.

This process tends to malfunction during fasting which results in lack of Insulin in the blood, leading to either of the two conditions called Hyperglycemia or Hypoglycemia.

• Hypoglycemia: This is a serious health condition where blood glucose levels drop below 70mg/dl. It requires immediate medical attention. If a person who is fasting feels shakiness or experiences headaches, sweating or lack of concentration, they must break their fast immediately to avoid any severe complications. Complications may range from seizures, coma to death. A bar of chocolate, a sugary drink or a small bowl of curd rice with sugar must be consumed if Blood Sugar Levels are exceptionally low. If a person breaks their fast on such an emergency, visit a doctor immediately.
• Hyperglycemia: This occurs when your sugar levels are as high as or more than 200mg/dl.  Common symptoms include extreme thirst, tiredness, and frequent urination. In such a situation, take advice from your doctor if you should continue your fast or not. Hyperglycemia affects each part of your body. If larger blood vessels are affected, you may face risks of stroke or a heart attack. On the contrary, if smaller blood vessels are affected, then you may face issues with your eyes, nerves and kidneys.
• Diabetic Ketoacidosis: This is a condition where Blood Glucose Levels go extremely high and a person experiences abdominal pain, rapid breathing, nausea and vomiting. It requires immediate medical attention. In such situations, it is best to consult with a doctor.
• Dehydration: While fasting, one may experience dehydration, especially those who work outdoors under the scorching heat of the sun. Due to lack of fluids, sugar may accumulate in the system, resulting in high blood sugar levels which can make you pass urine frequently. To overcome such dehydration during Ramadan, try to drink plenty of water after Iftar till Suhoor.

Managing Diabetes While Fasting During Ramadan

Fasting during the holy month of Ramadan is an individual’s decision. It can be managed with lifestyle changes, advice from a doctor and frequent monitoring. A few things you should consider are:

1. Pre-Diabetic Health Checkup: A Health checkup and monitoring your glucose levels before the month of Ramadan is necessary. You can also try fasting before Ramadan to see if you can manage it. Check your medication timings and discuss it with your doctor if you choose to fast.

If you consume medicines at Suhoor and keep a fast the entire day, chances are that your blood glucose levels might drop. Your blood glucose levels might even spike in the evening when you break your fast due to the intake of meals. Hence, discuss your medication timings and keep a glucometer handy to avoid medical emergencies.

2. Nutrition: If you are diabetic, ensure that both your meals are balanced. Opt for low Glycemic Index foods and Complex Carbs which digest slowly. Go for high fiber foods at Suhoor to manage blood glucose levels during fasts. Foods such as oats, Talbina (barley-based dish), brown rice, pasta and a bowl of vegetable salads work best.

Sorghum (Jowar) or Pearl Millet (Bajra) flattened bread (rotis) with Curd Raita is the best choice. A glass of buttermilk is also a good option. You can have Basil Seeds Water during Suhoor as it is rich in antioxidants, protein, good fats and fiber, all of which help in controlling diabetes.

A little protein in the form of chicken, fish, beans and legumes can also be included as they keep you full for a longer period of time and get absorbed slowly. However, people with kidney problems should take extra care to increase protein intake.

During Iftar, break your fast slowly. Chew properly and consume small amounts of food at different intervals as glucose levels may spike up if you consume a large meal at once. Have a small bowl of fruit salad or a glass of lassi (yogurt based drink) before heavy meals. Choose baked or grilled foods as compared to something fried and oily.

Sprouted salads, boiled chickpeas, or fruits are good options to include before you begin your meal. Don’t forget to hydrate yourself. Avoid sugary drinks or caffeinated beverages and choose fresh fruit juices such as beetroot juice or herbal iced tea.

We hope this article helps you stay healthy and maintain a fast without any complications or medical emergencies. If a medical emergency should arise, visit your doctor immediately.

If you found this article to be helpful, let us know your thoughts in the comments below. You can browse through more articles related to diabetes here.

If you need help or support managing Diabetes, join GOQii’s Diabetes Care Program. It’s India’s only diabetes program that is driven by Smart Science and Personal Coaching to improve Fasting Blood Sugar (FBS), Postprandial Blood Sugar (PP), and reduce HbA1c levels. You can subscribe here.

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