Fasting during Ramadan can be challenging for people with diabetes, but with certain precautions, many people with type 2 diabetes (and in some cases, type 1 diabetes) can fast more safely. Here are some important tips for staying healthy while fasting for people with diabetes:
General tips before starting to fast:
Consult your doctor:
Before starting to fast, be sure to consult your doctor to assess whether fasting is safe for you.
Adjusting medications:
The dosage and timing of medications, especially insulin or oral glucose-lowering medications, should be adjusted to suit your pre-dawn and iftar meals.
Education and awareness:
It is important to recognize the symptoms of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia). You need to know when to break your fast.
Nutritional tips:
Don’t skip pre-dawn meals:
Don’t skip pre-dawn meals. This meal should include high-fiber foods, complex carbohydrates (such as whole wheat bread, lentils, oats), and protein to provide more sustained energy throughout the day.
Balanced Iftar:
Continue breaking the fast with a light snack such as dates (1-2 at most), water, and then a balanced meal. Avoid eating heavy or high-fat foods all at once.
Limit sweets:
Avoid or minimize zulbia, okra, and other sweets; simple sugars cause severe blood sugar fluctuations.
Stay hydrated:
Drink enough water between iftar and sahur to prevent dehydration, as dehydration can raise blood sugar.
Blood sugar control:
Continuous monitoring:
Check blood sugar regularly, especially before and after sahur, in the evenings, and if you feel any abnormal symptoms.
Breaking the fast if necessary:
If your blood sugar drops below 70 or above 300 mg/dL, you should break your fast immediately to avoid serious complications.
Physical activity:
Avoid strenuous exercise during the day. A gentle walk after breaking your fast is more beneficial.
Physical activity is recommended in the later hours of the day or after breaking your fast.
Who should not fast:
People with uncontrolled type 1 diabetes.
People who experience frequent low blood sugar.
Patients with kidney failure or severe heart problems.
Diabetic pregnant women.
Suggested meal plan for healthy fasting for diabetics:
Suhoor meal (before the morning call to prayer):
| Food group | Examples |
|---|---|
| Complex carbohydrates | wholemeal bread, oatmeal, lentils, beans |
| Proteins | boiled eggs, low-fat cheese, probiotic yogurt, legumes |
| Vegetables | cucumbers, tomatoes, greens |
| Healthy fats | a small amount of olive oil, walnuts or almonds (3-5 pieces) |
| Drinks | water, light tea, low-fat milk without sugar |
Important note: Avoid eating salty and salty foods at suhoor so that you do not feel thirsty throughout the day.
Iftar (after Maghrib prayer):
| stage | Food recommendation |
|---|---|
| Starting iftar | 1 date + a glass of water or low-fat milk or light tea |
| Main meal | Barley soup, grilled chicken or fish, brown rice with cooked vegetables |
| Vegetables | Salad without dressing, steamed or stewed vegetables such as okra or pumpkin |
| Healthy fat | Olive oil, nuts in limited quantities (5 almonds or walnuts) |
Important note: Avoid sugary drinks, soda and fried fatty foods. Eat slowly and in small quantities.
Snack between iftar and sahur:
| Suitable options |
|---|
| A low-sugar fruit (such as apple or plum) |
| Low-fat yogurt or kefir |
| A small amount of nuts (almonds, walnuts) |
| Enough water (at different intervals) |
Additional tips for greater safety:
Carry a blood sugar meter throughout the day.
Have something to eat in case of low blood sugar:
Natural fruit juice, a spoonful of honey or dates
Be prepared to break the fast if you have any danger signs:
Excessive sweating, shaking, blurred vision, palpitations, dizziness or drowsiness
Common questions from diabetics about fasting
1. Is fasting permissible for all diabetics?
No. Many people with type 2 diabetes can fast with proper disease control, but people with type 1 diabetes or chronic complications (such as kidney, heart, or eye problems) usually should not fast unless under close medical supervision.
2. Can fasting lower blood sugar?
Fasting in diabetics may initially cause weight loss and improve insulin sensitivity, but if the diet or medications are not adjusted properly, the person may experience a sharp drop or increase in blood sugar. So a decrease in sugar is not always a sign of improvement.
3. Is fasting without eating suhoor dangerous for diabetics?
Yes, it is very dangerous. Skipping suhoor can increase the likelihood of blood sugar dropping during the day many times over and put a person at risk of hypoglycemia.
Warning signs to break the fast immediately
Break the fast immediately if any of the following occur:
| Dangerous condition | Brief explanation |
|---|---|
| Blood sugar below 70 mg/dL | causes lethargy, tremors, cold sweats, blurred vision, headache |
| Blood sugar above 300 mg/dL | can lead to diabetic ketoacidosis and unconsciousness |
| Signs of severe dehydration | Extreme thirst, little urine, dizziness, dry mouth and lips |
| Signs of severe hypotension or weakness | Lack of concentration, extreme fatigue, lethargy or fainting |
Healthy fasting checklist for diabetics:
Consult a doctor before the start of Ramadan
Regularly take medications and adjust the dosage according to the fasting schedule
Do not skip suhoor
Drink enough fluids between iftar and suhoor
Avoid sweets and harmful fats
Regularly measure blood sugar
Be aware of danger signs and be prepared to break the fast
Special recommendations for specific groups of diabetics
. Type 1 diabetes:
Doctors usually recommend that people with type 1 diabetes not fast unless they have very good control of their disease.
People who use an insulin pump or an insulin regimen with multiple injections per day should adjust their doses carefully and break the fast if their blood sugar drops.
. Pregnant or breastfeeding women with diabetes:
Fasting in this group can be dangerous and is usually not recommended.
Pregnant mothers with diabetes are at risk of hypoglycemia, reduced fetal growth, or dehydration.
. Elderly people with diabetes:
Elderly people may be more at risk of dehydration, blood pressure, and blood sugar fluctuations. If they decide to fast, they should have close medical supervision.
. Diabetics with chronic complications:
Those with kidney problems, heart disease, eye damage, or neuropathy should not fast because the risk of serious complications may be increased.
Simple daily monitoring plan during Ramadan (suggested):
| Time of blood sugar measurement | Blood sugar target (mg/dL) | Suggested action |
|---|---|---|
| Before Suhoor | 90–120 | If below 90, have a pre-suhoor snack |
| 2–3 hours after starting the fast | 100–180 | If below 70, break the fast |
| One hour before iftar | 90–120 | Monitor symptoms of hypo and hyper |
| 2 hours after iftar | Below 180 | If above, review nutrition and medication |
Final conclusion:
With proper preparation, meal planning, blood sugar control, and collaboration with a doctor, many people with diabetes can fast with relative safety. However, maintaining health takes precedence over fasting; If you feel unsafe, break your fast and protect your health.
Recommendations for the family and those around a diabetic person
Awareness of danger signs:
The family should recognize the signs of a severe drop or increase in blood sugar and know when to help the person or ask them to break the fast.
Accompanying them in appropriate meals:
Family members can help the diabetic person have a healthier diet by preparing balanced, low-sugar meals.
Avoiding psychological stress:
Never force a person to continue fasting if they feel unwell or have low blood sugar. Health always comes first.
The role of religious officials
Reminding the religious ruling:
According to most Islamic scholars, if fasting poses a risk to a person’s life, it is not obligatory and is even forbidden.
Emphasizing that God has permitted patients not to fast reduces feelings of guilt and psychological stress in these people.
Holding religious and medical briefing sessions for patients and families, especially in mosques and cultural centers, can be very effective.
Recommendations for healthcare professionals and health centers
Conduct Ramadan education courses for diabetic patients before the month begins, including:
Education on proper nutrition
Medication management
Learning about danger signs and how to deal with them
Provide brochures and simple checklists for patients in the office or pharmacy
Daily telephone or online follow-up for high-risk patients
The role of education and public awareness
Informing through the media, schools, mosques and social networks about the dangers of arbitrary fasting in diabetics can save many lives.
Encourage open discussions about health in family gatherings, instead of hiding or feeling ashamed.
Recommendations for the family and those around a diabetic person
Awareness of danger signs:
The family should recognize the signs of a severe drop or increase in blood sugar and know when to help the person or ask them to break the fast.
Accompanying them in appropriate meals:
Family members can help the diabetic person have a healthier diet by preparing balanced, low-sugar meals.
Avoiding psychological stress:
Never force a person to continue fasting if they feel unwell or have low blood sugar. Health always comes first.
The role of religious officials
Reminding the religious ruling:
According to most Islamic scholars, if fasting poses a risk to a person’s life, it is not obligatory and is even forbidden.
Emphasizing that God has permitted patients not to fast reduces feelings of guilt and psychological stress in these people.
Holding religious and medical briefing sessions for patients and families, especially in mosques and cultural centers, can be very effective.
Recommendations for healthcare professionals and health centers
Conduct Ramadan education courses for diabetic patients before the month begins, including:
Education on proper nutrition
Medication management
Learning about danger signs and how to deal with them
Provide brochures and simple checklists for patients in the office or pharmacy
Daily telephone or online follow-up for high-risk patients
The role of education and public awareness
Informing through the media, schools, mosques and social networks about the dangers of arbitrary fasting in diabetics can save many lives.
Encourage open discussions about health in family gatherings, instead of hiding or feeling ashamed.