Fasting during the holy month of Ramadan is an important spiritual practice. When you have diabetes, you may be wondering how fasting will affect your diabetes. There is a great deal of false information about diabetes and Ramadan. This handout is composed to respond to some of the most typical concerns.
- Ramadan Fasting
- Does everyone need to fast?
- I know lots of people with diabetes who fast and do not have an issue. Is it alright for me?
- What threats should I be aware of?
- I was told to not inspect my blood sugar during the day as it will break the fast. Is that true?
- How is low blood glucose dealt with?
- Do I stop taking medicine during Ramadan?
- How do I plan my meals considering that I’m only consuming two times a day?
- Answer from the Ulama
Does everyone need to fast?
No. This is based upon the Holy Quran in addition to the mentors of Islamic spiritual scholars over centuries. The Quran states that there are groups of people who do not have to fast, especially if it puts their health at risk. This consists of children, pregnant or breastfeeding women, the senior and anybody who might make themselves ill by fasting. This likewise consists of people with badly controlled diabetes, individuals with type 1 diabetes who take insulin or type 2 on a combined insulin routine or those who typically have extremely high or extremely low blood sugar levels.
I know lots of people with diabetes who fast and do not have an issue. Is it alright for me?
It is true, lots of people with diabetes can fast securely, but everyone is various. Part of the decision you will make with your doctor involves the type of diabetes medication you take. It is very important to set up a visit 2-3 months before Ramadan to discuss how fasting might affect your diabetes. Your doctor or doctor might suggest a modification in your medication plan.
What threats should I be aware of?
These are the essential risks:
- Low blood sugar (or hypoglycemia) — The risk of blood glucose levels going too low is greatest in individuals taking insulin or specific diabetes pills. Limit physical activity during fasting hours and be more active after sunset. Talk with your healthcare provider to find out if your medication puts you at risk for low blood glucose and go over how to prevent it.
- High blood sugar (or hyperglycemia) — While low blood sugar levels may take place throughout the day, after the fast is broken, there is a greater risk to overindulge. Watch out for consuming too many sugary foods and keep the portion sizes moderate. Although Ramadan is known as a time of fasting — it is not uncommon for people to gain weight during this month, as in some families, every night meal is an event.
- Dehydration — This is particularly a problem during the longer and hotter summer days. Goal to drink sugar totally free and caffeine free drinks regularly throughout the night and prior to dawn.
I was told to not inspect my blood sugar during the day as it will break the fast. Is that true?
Checking blood glucose will not break a fast! It is necessary to monitor blood glucose levels especially to recognize a low glucose level. A fast will need to be ended if glucose levels fall too low (listed below 70 mg/dl).
How is low blood glucose dealt with?
If glucose levels do fall below 70, take 15 grams of carbohydrate in the form of one of these: 4 glucose tablets, 6 oz routine soda, 4 oz fruit juice or 1 tube glucose gel. Wait 15 minutes and reconsider again. Follow with a treat if the evening meal is not for more than an hour.
Do I stop taking medicine during Ramadan?
No. You continue taking your diabetes medication, but you will take it at different times. Your dosage may also alter. This is one reason that it is essential to talk with your doctor a number of months prior to Ramadan so you can plan ahead for how your diabetes medications might have to change.
How do I plan my meals considering that I’m only consuming two times a day?
The dawn meal (Suhoor) need to contain a balance of entire grain sources of starchy carbs along with some protein and fat to help slow the digestion and help the feeling of fullness last as long as possible into the day. Healthy breakfast options great for the hot summer season of Ramadan consist of:
- Whole grain cereal, low-fat milk, home cheese with chopped peaches topped with toasted almonds.
- Plain Greek Yogurt flavored with blueberries and cinnamon, entire wheat toast with nut butter.
- Foul (a hearty middle eastern breakfast meal made of lentils or fava beans), small serving of sliced fruit.
- Whole wheat roti (unleavened bread) and egg khagina (a southeast Asian dish).
Generally the fast is broken (Iftar) after sunset and begins with the consuming of dates and drinking water. Limitation dates to 1-2 each night. Drink lots of water and sugar totally free drinks though out the evening, however avoid caffeine beverages as they can be dehydrating.
While the Iftar meal is an event time, aim to not eat way too much. Discuss a plan with your dietitian. Keep sensible parts in mind and follow the very same guidelines for healthy eating that you do the rest of the year with a focus on whole grains, lean sources of meat, fish and poultry, percentages of heart healthy fats and limit added sugars.
Answer from the Ulama
Q: I have diabetes type II wich is non insuline depend diabetes, I do not use any medication, I only controll diet and I do litle phisical exercise to keep in right level of my sugar (blood).
I have this decease one year and two monhts. Last Ramadan I fasted some days but I could not continue do to my low level of sugar (blood). This year I feel excellent (Alhamdu liLlah) I ONLY feel pain in my brain during fasting!? So my concern is, is it my DUTY to fast dispite my desease? Can test my blood during fasting times; “causing blood to come from my fingers”?
A: Praise be to Allaah.
It is prescribed for sick people not to fast in Ramadaan, if fasting will cause damage or make the illness even worse, or if they require treatment throughout the day through medicine or tablets that must be swallowed, due to the fact that Allaah says (interpretation of the meaning):
“and whoever is ill or on a journey, the same number [of days which one did not observe Sawm (fasts) must be made up] from other days” [al-Baqarah 2:185]
And the Prophet (peace and true blessings of Allaah be upon him) stated: “Allaah loves people to avail themselves of His concessions (rukhsah) just as He hates them to commit sin.” According to another version, “As He loves His commands to be obeyed.”
With regard to taking blood from veins for testing and so on, the appropriate view is that this does not break the fast, but if it is done typically, it is better to leave it till night-time. If it is done throughout the day then to be on the safe side that day must be comprised, due to the fact that this is akin to cupping.”
(Fatwa of Shaykh Ibn Baaz (might Allaah have grace on him), from Fataawa Islamiyyah, vol. 2, p. 139).
Sickness is of different kinds:
1 — That which does not impact the fast, such as a light cold or moderate headache or tooth pain, and so forth. In this case it is not acceptable to break the fast, despite the fact that some of the scholars permitted that because of the aayah (analysis of the significance):
“and whoever is ill…” [al-Baqarah 2:185]
However we say that this ruling is based upon a reason, which is that not fasting is simpler. If that holds true, then we would say that not fasting is better, but if fasting does not have an effect on him then it is not permissible to break the fast, and he has to fast.
2 — If fasting is hard for the ill individual, however it does not hurt him, then it is makrooh for him to fast and it is Sunnah for him to break his fast.
3 — If fasting is difficult for him and will cause him hurt, such as a man who has kidney disease or diabetes and similar cases where fasting will cause damage. In this case fasting is haraam. For this reason we might see that some mujtahids and sick individuals make a mistake when fasting is tough for them and might harm them, but they refuse to break their fast. We say that they are incorrect because they contradict the compassion of Allaah and the concession that He has provided to them, and they are harming themselves, although Allaah says (analysis of the meaning):
“And do not kill yourselves” [al-Nisa’ 4:29]
(al-Sharh al-Mumti’ by Shaykh Ibn ‘Uthaymeen, vol. 6, 352-254)
Sheikh Muhammed Salih Al-Munajjid