Can people with diabetes keep fast during Ramadan?

Can people with diabetes keep fast during Ramadan?
Experts recommend pre-Ramadhan counselling to safely fast during the holy month. @Shutterstock

Studies suggest that fasting may be helpful for some people with diabetes, but there are also many known risks associated it. Read to know which diabetic patients can undertake fasting, and who should avoid it.

Written by Longjam Dineshwori |Updated : April 30, 2020 8:35 AM IST

Fasting is the hallmark of Ramadan and it requires abstinence from food and drink (including water) from sunrise to sunset. All Muslim adults are obligated to observe the month-long sunrise-to-sunset fast. However, children, pregnant or breastfeeding women, and the elderly are exempted from this religious practice. How about people with underlying health conditions like diabetes - Is it safe for them to observe fasting during Ramadan?

Yes, it is safe for most diabetic patients to fast, but you should check with your doctor first. Because it could be dangerous for some people with complicated diabetes.

Many Muslims with diabetes all over the world keep fast during Ramadhan. Some studies suggest that fasting may be helpful for people with diabetes as it can help cut down on inflammation, promote weight loss, and lower cholesterol.

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A small study found that men with type 2 diabetes were able to stop taking insulin after fasting 3 days a week for a month. Within a year, they could stop taking other diabetes medications as well. Another study, including 10 obese men with type 2 diabetes, found improvement in their fasting glucose after following a time-restricted eating plan. The participants also lost weight over 6 weeks.

Your body takes about 12 hours to use glycogen, the extra glucose stored in your liver. When you don't eat for hours, your body will start burning fat instead of glycogen for energy. This way fasting helps you lose weight.

Caution: Fasting is not recommended as a technique for diabetes management and much of the research on fasting has been done in lab animals.

Risks associated with fasting

Before you undertake fasting, you should know the risks associated with fasting and how to avoid them. Fasting may make you feel drowsy, irritable as well as give you a headache. And if you continue fasting for more than a day, your body may not get enough nutrients it needs to function properly.

If you're taking medication like insulin to control your diabetes, fasting may turn out to be very dangerous for you. If you don't eat, your blood sugar levels could go dangerously low. This condition is called hypoglycemia, and it can cause you to feel shaky, pass out, or even go into a coma.

The opposite may happen when you break your fast. If you eat too many carbohydrates after fasting, you may develop hyperglycemia, which occurs when your blood sugar levels go too high.

So, fasting may not be safe if you have type 1 diabetes, other diabetes-related health problems, and hypoglycemia.

In addition to the timings of meals, Ramadhan fasting may disrupt sleeping patterns and hormonal rhythms. This can affect your metabolic state. Dehydration and diabetes ketoacidosis are other complications of fasting.

Signs that you should stop fasting

If you have already started fasting, watch out for these warning signs.

Too-low blood sugar or hypoglycaemia may make you feel shaky, sweaty, or confused. Stop fasting right away if you start experiencing these symptoms and talk to your doctor to treat the condition.

Avoid eating too many carbohydrate-rich foods after fasting, it can cause your blood sugar levels to become too high. Also, don't take caffeine beverages as they can be dehydrating. Don't do hard exercises while you're fasting as it can make your blood sugar levels dip. You can continue you're your routine morning walk.

Take away

People with diabetes should keep fast during Ramadhan only after discussion with their doctor. Experts recommend pre-Ramadhan counselling to safely fast during the holy month. Consult your physician at least 2-3 months before the holy month to discuss lifestyle modification, diet and medication accordingly.