Fasting safely this Ramadan - expert advice for Muslims with diabetes
Ramadan, the ninth month in the Islamic calendar when Muslims devote themselves to their faith and fast from sunrise to sunset, starts next week.
Lasting until early June, the Ramadan fasting period is obligatory for almost all Muslims. Although certain groups are exempt for health and other reasons, some people with diabetes are keen to observe the fast, although the long daylight hours in the UK at this time of the year makes it a challenging time, even for those without medical conditions.
Diabetes UK has highlighted that: “long fasts of 15 hours or more can put people at higher risk of hypoglycaemia and dehydration, which can make you ill”.
To help people to fast safely, the diabetes clinical steering group from Hertfordshire and West Essex Sustainability and Transformation Partnership (STP) is encouraging people to seek advice from their GP and Imam before starting their fast and has encouraged people to bear in mind this practical advice:
- Appropriate portion sizes (for example 1-2 dates are the recommended amount to break the fast due to high sugar content)
- Reduced carbohydrate content (this has the most impact on blood glucose levels)
- Glycaemic index (low GI foods e.g. brown/basmati rice or porridge/shredded wheat help keep blood glucose stable)
- Cooking methods (baking rather than frying)
- Using healthier options where possible (balanced meals with vegetables and salad)
- Hydration (sugar content should also be considered in drinks)
Jenne Patel, Diabetes Quality Improvement Manager, Hertfordshire and west Essex Sustainability and Transformation Partnership, added:
“People with diabetes who fast are at risk of experiencing high and low blood glucose levels. They also need to be aware that there are changes to the body during fasting, so they may need to change when and how they take any medication that they rely on. Speak to your community pharmacist for individual advice.”
Professor Jim McManus, Director of Public Health at Hertfordshire County Council, said:
“Fasting can be good for us, as many faiths will attest to. It can however also have risks if you have ongoing health conditions. It’s therefore important if you are going to fast during the Holy Month of Ramadan to speak to your Imam and Doctor if you have any long term conditions, especially diabetes.
“You may be exempt from fasting but even if you’re exempt and want to fast, and if you have diabetes particularly, you should get medical advice before you fast and take care when you break the fast.”
- Hertfordshire and west Essex STP has published a table highlighting those at high, medium and low risk on their website (see below).
- For further advice, the Diabetes UK website is a useful source of information www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/ramadan
- Alternatively you can call the Diabetes UK Helpline on 0345 123 2399. If you wish to speak in a language that is not English, this can easily be arranged.
- Some useful guidelines can also be found here, written by Muslims for the Holy Month. https://www.hey.nhs.uk/patient-leaflet/diabetes-ramadan-guidance-fasting-holy-month/.”
1. Ramadan this year starts either on Monday the 6th of May or Tuesday the 7th; exact date depends on Moon sighting.
2. The Qur’an states that those who are exempt from fasting include:
- Women who are menstruating
- Elderly or frail patients
- Those suffering with a severe mental illness or condition
- Those suffering with a chronic illness, where fasting can cause detriment to health
3. Table of risks and associated advice (Reference: Ali S et al. Guidelines for managing diabetes in Ramadan. Diabetic Medicine 2016)
High risk conditions – where fasting is not advised
Moderate risk – May fast if patient and health-care professionals are happy, with collaboration of care between all involved
Low risk - Should be able to fast with advice