While fasting during Ramadaan brings many benefits to diabetic people, such as losing weight, there are also associated risks.
Ramadaan is the most sacred month of the year for Muslims. It is estimated there are 148 million Muslims with diabetes across the world, of whom over 116 million may fast during Ramadaan.

Muslims observe the holy month of Ramadaan by abstaining from food, drink and oral medications from dawn to sunset.

While fasting has many benefits for diabetic people, such as losing weight, there are also associated risks.

Although the Qur’an exempts people with a medical condition from the duty of fasting, many people living with diabetes still choose to fast, despite the health risks.

Dr Aneesa Sheik, medical director of Lilly South Africa says: “Fasting presents significant challenges for people living with diabetes in terms of managing blood sugar levels, which is why it’s essential for them to consult with their doctor well in advance of the holy month of Ramadaan, to find out if they can fast and, if so, plan a way to do it safely.”

A study led by Dr Mohamed Hassanein published on the International Diabetes Federation website says an individualised management plan, nutritional plan, as well as medication adjustments should be considered before fasting to combat the health hazards.

“The rising prevalence of diabetes in the Muslim population, combined with the high numbers that participate in fasting, creates a pressing need for effective guidance for the management of diabetes during Ramadaan” says Hassanein.

Muslims wake up well before dawn to eat the first meal of the day, and have to abstain until sunset.

That can be challenging for people living with diabetes, particularly for patients with type 1 diabetes, who are dependent on insulin.

Sheik says the lack of food and water during the day, along with the heavy meals eaten before and after fasting, can create serious health issues for people living with diabetes.

“This can lead to serious complications among which are low or high blood sugar levels.

“A blood sugar level that is too low and left untreated can cause confusion, clumsiness, or fainting, and in the case of severe low blood sugar, can lead to seizures, coma, and even death. A high blood sugar level can damage blood vessels, and over a long period of time can result in serious complications, including irreversible organ damage,” says Sheik.

“If you have type 1 diabetes or you are a high risk type 2 diabetes patient, guidelines advise that you should not fast.

“However, should you choose to fast, your doctor will want to ensure that your blood sugar is regularly monitored to prevent any health risks, and may even need to adjust medication doses according to your food intake and activity.

“It is important to remember that your prescribed medication may also influence your ability to fast,” says Sheik.