Is it safe to fast during Ramadan if I have diabetes? Are there any other steps I should take to safely fast?
Answer From M. Regina Castro, M.D.
It's safe sometimes. Some people may choose to not eat for a period of time (fast) for religious reasons, such as from dawn to sunset during the Islamic holy month of Ramadan.
However, talk with your doctor before you fast. He or she will likely explain potential risks of complications such as low or high blood sugar and dehydration. Your doctor may suggest that you avoid fasting if you're at high risk of complications. If you choose to fast, your doctor and diabetes care team will likely provide you with education about managing your diabetes and adjusting your medications or insulin doses.
You may have a high risk of complications if you fast during Ramadan and you have one or more of the following:
- Type 1 diabetes
- Type 2 diabetes with poor blood sugar control
- Recent history of severe low blood sugar or diabetic ketoacidosis
- History of recurring low blood sugar or unawareness of low blood sugar
- Conditions such as severe kidney disease or blood vessel complications
- Diabetes and are pregnant
But it may be safe for you to fast with diabetes during Ramadan if you:
- Have type 2 diabetes that's well-controlled
- Manage diabetes with medications or lifestyle therapy
If you choose to fast during Ramadan, your doctor and diabetes care team will likely recommend that you:
- Closely monitor your blood sugar
- Adjust your medication doses
- Watch for signs of low blood sugar
- Follow your doctor's suggestions about food, drink and exercise
- Be ready to stop fasting if you have low or high blood sugar
You may be able to fast safely during Ramadan if you understand the risks, manage your diabetes and carefully follow your doctor's recommendations.
M. Regina Castro, M.D.
March 27, 2021
- Levesque C. Therapeutic lifestyle changes for diabetic mellitus. The Nursing Clinics of North America. 2017;52:679.
- International Diabetes Federation and the DAR International Alliance. Diabetes and Ramadan: Practical Guidelines. Brussels, Belgium: International Diabetes Federation, 2016. https://www.idf.org/e-library/guidelines/87-diabetes-and-ramadan-practical-25. Accessed Feb. 26, 2019.
- Hassanein M, et al. Diabetes and Ramadan: Practical guidelines. Diabetes Research and Clinical Practice. 2017;126:303.