Fasting Made Simpler for Diabetics

Experts remind us that safe fasting for those with diabetes rests on two steady pillars - mindful nourishment and regular glucose monitoring.

Dr. Rajaneesh Kumar, Internal Medicine Specialist at Al Hilal Hospital, Muharraq, recommends checking blood sugar before Suhoor, two hours after, around noon, mid-afternoon, before Iftar, and two hours after Iftar to prevent emergencies. Using a continuous glucose monitor can make this easier, reducing the need for frequent finger-prick tests. Patients should also check anytime they feel dizzy, weak, or confused.

“Blood glucose below 70 mg/dL or above 300 mg/dL, or sudden shakiness, confusion, or heavy sweating, needs immediate attention. Hypo glycemia can be treated with 15–20 g of fast-acting carbs, like a glass of juice or glucose tablets, followed by a recheck in 15 minutes. If levels stay dangerously low or the person is unresponsive, call emergency services immediately,” says Dr. Rajaneesh.

Diabetic medications specifically sulfonylureas, or insulin may require dose or timing changes or switching to safer alternatives for Ramadan. Even if a pre-Ramadan consultation was missed, it is never too late to seek guidance.

Suhoor, Dr. Rajaneesh emphasizes, is the foundation of the fasting day, a quiet strength before dawn. Whole grains, fiber-rich vegetables, eggs or legumes, healthy fats like avocado or nuts, and two to three glasses of water help build endurance. Large portions, sugary drinks, and refined carbohydrates may promise comfort but bring midday crashes.

At Iftar, moderation is wisdom. The traditional mix of rich dates, sweet drinks, and hearty dishes can trigger hyperglycemia, Dr. Rajaneesh notes. It’s better to limit dates to one to three, drink water, wait for 20 minutes, then start the meal with salads and protein, keep complex carbs small, and follow with a gentle 15 - 20 minute walk.

Exercise

Light to moderate exercise is generally safe for those with well-controlled diabetes, ideally 30 - 60 minutes before Iftar, one to two hours after, or after Tarawih. Avoid mid-afternoon or post-Suhoor workouts. Always check glucose and carry fast-acting carbs, says Dr. Rajaneesh.

Experts warn that high-risk individuals including pregnant women with gestational diabetes, children with Type 1 diabetes, and those with recent DKA, frequent severe hypoglycemia, poorly controlled diabetes, or kidney or heart disease should be very cautious about fasting.

With careful planning and attention, people with diabetes can fast safely and still enjoy the spiritual rewards of Ramadan.