Fasting for Diabetics
Recognise your risk before you fast
In holy Ramadan, many patients with Diabetes face medical challenges during fasting hours in Ramadan. Perfect planning is therefore necessary to avoid complications and help perform all the rituals of Ramadan. When fasting is hazardous * Brittle or poorly controlled Diabetes Mellitus (DM) * Patients on insulin pump * Patients on multiple insulin injections per day * Severe hypoglycemia (low level of blood sugar) * Diabetic complication like eye problem, heart disease etc When people can fast with caution * Well controlled DM * No recent hypoglycemia * Not more than 2 injections per day In general, patients with type 1 diabetes (childhood diabetes), especially if "brittle" or poorly controlled, are at very high risk of developing severe complications and should be strongly advised to not fast during Ramadan. In addition, patients who are unwilling or unable to monitor their blood glucose levels multiple times daily are at high risk and should be advised to not fast. On the other hand, an excessive reduction in the insulin dosage in these patients (to prevent hypoglycemia) may place them at risk for hyperglycemia and diabetic complications. Hypo- and hyperglycemia may also occur in patients with type 2 diabetes (adult onset diabetes) but generally less frequently and with less severe consequences compared with patients with type 1 diabetes. A patient's decision to fast should be made after ample discussion with his/her physician concerning the risks involved. Patients who insist on fasting should undergo pre-Ramadan assessment and receive appropriate education and instructions related to physical activity, meal planning, glucose monitoring, and dosage and timing of medications. Close follow-up is essential to reduce the risk for development of complications.
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