Managing the risk of fasting and Diabetes during Ramadan

If you are diabetic and a Muslim and would still like to fast in the holy month of Ramadan, can it be done?

It’s tricky, but may be possible, says Dr Aneesa Sheik, medical director of Lilly South Africa, who gives suggestions for how Muslims can approach this holy month, which in 2019 starts in the first week of May.

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

This practice is referred to as fasting, where only two meals are eaten daily, one before dawn and one after sunset.

Given its significance in the Islamic faith, not being able to fast due to a health condition can be devastating to people.

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

It is estimated that there are 148 million Muslims with diabetes across the world, of whom more than 116 million may fast during Ramadan, which starts in 2019 on the evening of Monday May 6, subject to the sighting of the new moon, to Wednesday June 5 2019.

“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 Ramadan, to find out if they can fast and if so, plan a way to do it safely,” Sheik says.

“The lack of food and water during the day, along with the heavy meals eaten before and after fasting at suhoor and ifthar can create serious health issues for people living with diabetes, as they are faced with major disruptions to their diet and daily routines.

“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.

“In general, fasting can be very challenging for people living with diabetes, particularly for patients with type 1 diabetes, who are dependent on insulin.

“If you have type 1 diabetes or you are a high risk type 2 diabetes patient, guidelines¹ 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.

“Muslims with diabetes who wish to fast must plan diligently and well in advance for a safe and healthy Ramadan,” Sheik says.

Providing healthcare professionals with the right tools and resources for people with diabetes wanting to fast during Ramadan remains a key focus area for Lilly.

Please speak to your doctor or diabetes nurse educator for more Ramadan-specific educational tools – at least four to six weeks before the start of Ramadan – to ensure a safe and spiritual month.